ABSTRACT
@#Cerebral air embolism caused by lung cancer is extremely rare, especially if not associated with invasive procedures such as needle biopsy. We describe the case of an 86-year-old man with squamous cell lung carcinoma of the left lung. He developed a bad cough and subsequently suffered left hemiplegia. Brain computed tomography (CT) on admission showed no abnormal findings. Diffusion-weighted magnetic resonance (MR) imaging revealed high intensity lesions in the right frontal lobe and right parietal lobes. Repeated brain CT revealed air densities around the high intensity lesions on previous MR imaging, compatible with air embolism causing cerebral infarction. Chest CT confirmed a left pulmonary hilar mass invading the left pulmonary vein, left atrium, and main bronchus. Air densities were found in the left heart ventricle. These radiological findings were attributed to cerebral air embolism associated with advanced lung cancer. Shortly afterwards he died of progressive respiratory failure. Our case reveals two important aspects. First, cerebral air embolism can be caused by lung cancer invading the pulmonary vein, left atrium, and main bronchus without iatrogenic causes. Therefore, we should pay special attention to the etiology when the patients with lung cancer in the advanced stage developed cerebral infarction. Second, repeated CT is recommended if cerebral air embolism is suspected because initial head CT does not always reveal air bubbles.
ABSTRACT
Cerebral air embolism is an uncommon disorder, but it can result in significant morbidity and even mortality. Cerebral air embolism during esophago-gastro-duodenoscopy is also rare, but has in recent years been repeatedly reported. We report here a patient with cerebral infarction due to air embolism during endoscopic variceal ligation in liver cirrhosis. The patient was later confirmed to have patent foramen ovale. To our knowledge, this is the first report of such a complication with underlying patent foramen ovale and portal hypertension, who did no have underlying malignancy
ABSTRACT
Symptomatic cerebral air embolism during cerebral angiography is extremely rare. We report on the case of a 69-year-old woman undergoing elective stent-assisted coiling of an unruptured right middle cerebral artery (MCA) bifurcation aneurysm, who was found to have severe attenuation of somatosensory evoked potential (SSEP) and electroencephalography (EEG) during the procedure. Intra-operative DynaCT showed hypodense cortical vessels consistent with cerebral air embolism. Diagnostic and management strategies for this rare complication are reviewed.
Subject(s)
Aged , Female , Humans , Aneurysm , Cerebral Angiography , Diagnosis , Electroencephalography , Embolism, Air , Evoked Potentials, Somatosensory , Intracranial Aneurysm , Middle Cerebral ArteryABSTRACT
Cerebral air embolism is an unusual event that is mainly an iatrogenic cause, such as open heart surgery. We present a case of cerebral air embolism in a patient undergoing ASD patch repair with cardiopulmonary bypass. He had a status epilepticus, loss of consciousness and marked left limb weakness immediately after the operation. Diffusion-weighted MRI with angiography showed acute infarction in right entire hemisphere with patent internal carotid and intracranial arteries, and glucose PET brain scan showed severe decreased uptakes in right hemisphere. He recovered markedly with mild motor impairment of left upper and lower limbs in the 6 months after onset.
Subject(s)
Humans , Angiography , Arteries , Brain , Cardiopulmonary Bypass , Embolism, Air , Extremities , Glucose , Heart , Infarction , Lower Extremity , Status Epilepticus , Thoracic Surgery , UnconsciousnessABSTRACT
Cerebral air embolism, the entry of air into the cerebral artery, is an iatrogenic clinical problem in most cases, which may result in seizure, severe neurologic deficits and even death. Although cerebral air embolism may result from almost all procedures that are performed in clinical specialties, occurrence following a gastroscopy is very rare. We report a patient who developed cerebral air embolism following a gastroscopy.
Subject(s)
Humans , Cerebral Arteries , Embolism, Air , Gastroscopy , Neurologic Manifestations , SeizuresABSTRACT
No abstract available.
Subject(s)
Humans , Catheterization, Central Venous , Central Venous Catheters , Embolism, Air , Idiopathic Pulmonary FibrosisABSTRACT
CT-guided transthoracic needle biopsy is a common procedure for the evaluation of pulmonary and mediastinal lesions. The most frequent complications include pneumothorax, hemorrhage, and hemoptysis. Air embolism especially cerebral embolism is rare but potentially fatal complication after this procedure. Here, we report a case of cerebral air embolism occurred after CT-guided transthoracic needle biopsy for the peripheral lung mass.
Subject(s)
Biopsy, Needle , Embolism, Air , Hemoptysis , Hemorrhage , Intracranial Embolism , Lung , Needles , PneumothoraxABSTRACT
The author used in vivo P nuclear magnetic resonance spectroscopy to determine the effect of cerebral air embolization and nimodipine, phenylephrine, pentobarbital and ketamine on changes of pH and PCr/Pi in 35 cats After anesthetizing animals by 15mg/kg/hr iv of pentobarbital in control, nimodipine, nimodipine plus phenylephrine and phenylephrine group or 6 mg/kg/hr of ketamine iv in ketamine group, air was introduced into the carotid artery and 10 ug iv of nimodipine every 6 min or 0.1% phenylephrine iv infusion to maintain mean arterial blood pressure were given. There were tendencies that mean arterial blood pressure increased immediately after infusion of air and recovered baseline value in phenylephrine, nimodipine plus phenylephrine and ketamine groups but remained lower than baseline vaIue in pentobarbital and nimodipine group(P<0.05). The pH decreased in 6 min and returned to baseline within 24 min in all groups and PCr/Pi decreased in all cats in 6 min and recovered baseline value but remained low values in control and nimodipine group without statistical significance. The results suggest that cerebral ischemia by air embolism was aggravated by vasodilating and hypotensive action of nimodipine and was ameliorated by maintaining or elevating blood pressure by phenylephrine, and also ketamine anesthesia showed faster recovery of brain metabolism than pentobarbital anesthesia, but these findings were only the tendencies and further study is recommended.