Abstract
We describe a 65-year-old man who presented to the emergency department with acute cerebral air embolism after receiving computed tomography guided lung biopsy. The patient presented with muscle strengths of 0/5 in left arm and 3/5 in left leg, aphasia, and a right pneumothorax. Our concern was to improve the patient's neurological function, while ensuring stability in a patient who possibly had systemic air embolism and a penumothorax, which is a contraindication to hyperbaric treatment. To that end, we treated the patient with therapeutic hypothermia for 24 hours. The patient went on to recover full neurological functions.
Highlights
We describe a 65-year-old man who presented to the emergency department with acute cerebral air embolism after receiving computed tomography guided lung biopsy
CASE A 65-year-old man presented to the emergency department (ED) after a computed tomography (CT) guided lung biopsy by interventional radiology with an acute cerebral air embolism
The patient was stable upon presentation, the patient presented acutely following air embolism introduced into the vasculature and needed to be in a closely monitored setting, such as in the ED, that was prepared for resuscitation
Summary
We describe a 65-year-old man who presented to the emergency department with acute cerebral air embolism after receiving computed tomography guided lung biopsy. CASE A 65-year-old man presented to the emergency department (ED) after a computed tomography (CT) guided lung biopsy by interventional radiology with an acute cerebral air embolism. The patient subsequently presented to the interventional radiology suite for a CT guided lung biopsy, which later revealed adenocarcinoma. He received Versed and fentanyl for the procedure but remained alert and conversive during the procedure. He had 3/5 in muscle strength on the left lower extremity and was responding sluggishly to noxious stimuli Throughout his assessment, the patient was placed in Trendelenburg position while receiving 100% oxygen via nonrebreather mask. Upon initial assessment following extubation, the patient was alert, oriented, and exhibited 2/5 muscle strength in the left upper extremity and 3/5 muscle strength in the left lower extremity, which was an improvement from the left upper
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