Intraventricular Air Embolus Causing Ischemic Stroke after Lung Biopsy

Abstract

Gas embolism is a rare potentially fatal pathology and a recognized cause of cerebral ischemia and stroke [1,2]. It is a dreaded complication following invasive medical procedures, such as transthoracic needle biopsy, traumatic lung injury and decompression accidents [3-7]. Arterial gas embolism is caused by the entry of gas into the pulmonary veins or directly into the arteries of the systemic circulation [8]. Another mechanism takes place when gas enters the arterial circulation through a right-to-left cardiac or intrapulmonary shunt or if passage of bubbles through the pulmonary capillary bed occurs. Injection of 2 ml of air into cerebral circulation can be fatal [9]. Cerebral lesion can result from intracranial artery occlusion, platelet clot development on the gas-blood interface, endothelial lesion or inflammatory activation. The purpose of this study is to report an uncommon cause of stroke following an invasive medical procedure and its management.