Cerebral Air Embolism Research Articles

Middle cerebral artery hypodense dot sign in iatrogenic air embolism.

Air embolism is a rare cause of stroke, usually associated with medical procedures, with gastrointestinal endoscopy rarely implicated. Here, we present a case of a patient who experienced cerebral air embolism post-gastroscopy, presenting with aphasia and right hemiparesis due to left M2 occlusion with spontaneous and complete recovery. CT scan revealed a hypodense defect in the left Sylvian fissure, representing a "hypodense dot sign" suggestive of an air embolism. The hypodense MCA sign, previously described in fat embolism cases, could also indicate air embolism, supporting prompt diagnosis and proper intervention.

Characteristic MR Imaging Findings of Cerebral Air Embolism Infarcts: A Case Series.

Infarcts from cerebral air embolism are rare events with potentially catastrophic clinical consequences. The imaging features of cerebral air embolism are not well-defined in the literature. We report a novel constellation of MR imaging findings of cerebral arterial air emboli-induced infarcts in a series of 6 patients. Awareness of the more distinguishing MR imaging patterns of cerebral air embolism may help establish this diagnosis and facilitate implementation of timely treatment.

Experimental Model of Cerebral Arterial Air Embolism in Conscious Rats.

In this work, an optimal air supply mode was selected to create a model of cerebral arterial air embolism (CAAE) on conscious male Sprague-Dawley rats (n=49). The efficacy of the selected model (administration of 100 μl/kg of air at a rate of 10 μl/min with an infusion pump) was determined by changes in serum biochemical parameters (cholesterol, alkaline phosphatase, inorganic phosphates, AST, and triglycerides), impaired motor functions in the Rotarod test, and visual assessment of the ischemic foci (staining of frontal sections with 1% triphenyltetrazolium chloride solution) at different terms after AAE. The model of AAE created by us confirmed impairment of coordination and motor function in conscious animals and reproduced the lethal consequences of this condition. The obtained results can serve as the basis for drug testing and the development of new approaches to the treatment of ischemic stroke.

Catheter ablation for atrial fibrillation, atrio-oesophageal fistula, cerebral air embolism, and hyperbaric oxygen therapy

Catheter ablation for atrial fibrillation, atrio-oesophageal fistula, cerebral air embolism, and hyperbaric oxygen therapy

Ischaemic Strokes Caused by Spontaneous Cerebral Air Embolism, A Rare Complication of Interstitial Lung Disease.

This case demonstrates a mechanism of stroke in patients with severe interstitial lung disease (ILD) that has not been previously described, and we suggest that in cases of advanced ILD, clinicians should consider this as a possible mechanism of stroke. The management of these patients should include transferring them to hyperbaric facilities to prevent further air emboli.

Cerebral arterial air embolism after esophageal stenting for recurrence of gastroesophageal junction cancer: a case report.

Cerebral arterial air embolism (CAE) is a rare complication after esophageal stenting, but it can be life-threatening. It is especially a concern for those with a history of previous gastrointestinal cancer therapies. We report a case of CAE after esophageal stenting in a patient with recurrent gastroesophageal junction cancer and a history of multiple cancer treatments. A 71year-old man with a history of a proximal gastrectomy, resection of the lower esophagus, chemotherapy, and radiation presented to our hospital 2weeks after stenting with epigastric and back pain. Mediastinitis was suspected and conservative treatment was begun. The patient suddenly developed altered mental status, left hemiplegia, and anisocoria after drinking water. A brain computed tomography (CT) revealed right-sided predominance of multifocal CAE. Chest and abdominal CT showed a hematoma in the gastric and duodenal wall and an intraluminal hematoma from the esophagus, around the stent, to the upper ileum. CAE was thought to be due to rupture of the recurrent tumor. Unfortunately, despite intensive care, the patient died about 5h after the onset of neurological symptoms. It has been reported that prior treatments, such as chemotherapy and radiotherapy, increase the risk of life-threatening adverse events, including CAE after esophageal stenting. Clinicians should keep in mind the possibility of CAE after esophageal stenting in patients with a history of multiple cancer treatments.

Cerebral air embolism: neurologic manifestations, prognosis, and outcome.

Cerebral air embolism (CAE) is an uncommon medical emergency with a potentially fatal course. We have retrospectively analyzed a set of patients treated with CAE at our comprehensive stroke center and a hyperbaric medicine center. An overview of the pathophysiology, causes, diagnosis, and treatment of CAE is provided. We retrospectively identified 11 patients with cerebral venous and arterial air emboli that highlight the diversity in etiologies, manifestations, and disease courses encountered clinically. Acute-onset stroke syndrome and a progressive impairment of consciousness were the two most common presentations in four patients each (36%). Two patients (18%) suffered from an acute-onset coma, and one (9%) was asymptomatic. Four patients (36%) were treated with hyperbaric oxygen therapy (HBTO), high-flow oxygen therapy without HBOT was started in two patients (18%), two patients (18%) were in critical care at the time of diagnosis and three (27%) received no additional treatment. CAE was fatal in five cases (46%), caused severe disability in two (18%), mild disability in three (27%), and a single patient had no lasting deficit (9%). Cerebral air embolism is a dangerous condition that necessitates high clinical vigilance. Due to its diverse presentation, the diagnosis can be missed or delayed in critically ill patients and result in long-lasting or fatal neurological complications. Preventative measures and a proper diagnostic and treatment approach reduce CAE's incidence and impact.

Effect of a helium and oxygen mixture on physiological parameters of rats with cerebral arterial air embolism.

Introduction: Cerebral arterial air embolism (CAE) is a serious and potentially dangerous condition that can interrupt the blood supply to the brain and cause stroke. One of the promising gas mixtures for emergency treatment of air embolism is an oxygen-helium mixture. Methods: We modeled CAE in awake rats by injecting air into the common carotid artery. Immediately after CAE, animals were either untreated or underwent hyperbaria, oxygen inhalation, heated air inhalation, or helium-oxygen mixture inhalation. Body temperature, locomotor activity, respiratory and cardiovascular parameters were monitored in the animals before CAE modeling, and 3 and 24h after CAE modeling. Results: After 3 hours of CAE modeling in awake rats, depression of the nervous, cardiovascular and respiratory systems, as well as decreased body temperature were observed. 24h after CAE modeling multifocal cerebral ischemia was observed. Normobaric helium-oxygen mixture inhalation, on par with hyperbaric treatment, restored body temperature, locomotor activity, respiratory volume, respiratory rate, and blood pressure 3 hours after CAE, and prevented the formation of ischemic brain damage lesions 24h after CAE. Discussion: Thus, inhalation of a heated oxygen-helium gas mixture (O2 30% and He 70%) immediately after CAE improves the physiological condition of the animals and prevents the foci of ischemic brain damage formation.

Cerebral Air Embolism Following Pressurized Peripheral Intravenous Fluid Bolus

Cerebral Air Embolism Following Pressurized Peripheral Intravenous Fluid Bolus

Necrotizing Pneumonia and Cerebral Air Embolism

Necrotizing Pneumonia and Cerebral Air Embolism

Cerebral air embolism following blunt chest trauma diagnosed on post-mortem CT

Cerebral air embolism following blunt chest trauma diagnosed on post-mortem CT

Cerebral Air Embolism After Endoscopy: A Case Report.

Cerebral air embolisms are a rare but potentially devastating event where air enters the vascular system. Although commonly associated with intravascular catheters, they can arise from a variety of mechanisms including endoscopic procedures. We report the case of a 90-year-old woman who presented with focal neurologic deficits due to an air embolism after undergoing an esophagogastroduodenoscopy. Cerebral air embolisms should be considered in patients who present to the emergency department with acute neurologic changes, especially after an endoscopic procedure.

Cerebral air embolism following a hemodialysis session successfully treated with hyperbaric oxygen: a case report

We describe here the first case of cerebral air embolism (CAE) due to a dysfunctional long-term central venous catheter for hemodialysis in a 39-year-old woman with a history of lung transplantation. Air emboli are rare but potentially fatal complications of hemodialysis, in particular, when they involve the brain. Early management with hyperbaric oxygen therapy (HBOT) is critical to prevent deterioration of the patient’s condition. In this case, our patient presented her first symptoms, likely a seizure due to multiple cerebral air emboli, during her hemodialysis session. She was then monitored in the Nephrology Intensive Care Unit in accordance to the medical reference center (with HBOT). Twelve hours later, she experienced secondary deterioration, presenting with acute aphasia, left hemineglect syndrome, and hemiplegia. She was rapidly transferred to the medical reference center for HBOT. The patient fully recovered after receiving three sessions of HBOT. She also presented a seizure during each HBOT session, attributed to hyperoxia. She never experienced another seizure after the episode of CAE. This case highlights the importance of considering patients who have a lung transplant to be at increased risk for air emboli during hemodialysis and the need to rapidly recognize symptoms and start treatment, including HBOT, to optimize recovery.

Cerebral air embolism without invasive medical procedures diagnosed by characteristic hypointense signal on T2*-weighted imaging

Cerebral air embolism without invasive medical procedures diagnosed by characteristic hypointense signal on T2*-weighted imaging

Cerebral venous air embolism after neurosurgical intervention: A case report and literature review

Cerebral venous air embolism after neurosurgical intervention: A case report and literature review

Subclinical to catastrophic: a range of outcomes in cerebral air embolism.

Cerebral air embolism (CAE) is a rare, yet potentially devastating condition characterized by entrance of air into cerebral vasculature, that is nearly always iatrogenic. While many findings of CAE are subclinical and incidental at computed tomography (CT), there remain cases of catastrophic and fatal embolisms. Increasing physician awareness of prevention, presentation, and treatment for CAE is crucial for reducing morbidity and mortality. In this case series, we highlight this preventable entity by comparing three cases of CAE that showcase a diverse array of presentations, radiologic findings, and clinical outcomes. We will also explore predisposing factors, prognostic predictors, diagnostic considerations, and available treatments.

Cerebral air embolism after computed tomography-guided percutaneous transthoracic lung biopsy: a case description.

Cerebral air embolism after computed tomography-guided percutaneous transthoracic lung biopsy: a case description.

Cerebral venous air embolism – Rare complication after central venous catheterization

Cerebral venous air embolism (CVAE) is a rarely reported but potentially disastrous complication associated with manipulation or accidental disconnection of a central venous catheter. This case report brings up one such case of a 62-year-old male who presented with altered sensorium post central venous catheterization and was promptly diagnosed to have developed CVAE based on multi-detector computed tomography imaging.

Cerebral Air Embolism during Pleural Lavage

Cerebral Air Embolism during Pleural Lavage

Non-Iatrogenic Cerebral Air Embolism: A Case Report of an Extremely Rare Cause of Ischemic Stroke (P6-5.031)

<h3>Objective:</h3> NA <h3>Background:</h3> Air embolism is an uncommon but potentially catastrophic event due to air entry into the vasculature resulting in ischemic strokes. Cerebral air embolism (CAE) can be a complication of medical procedures, although non-iatrogenic sources have rarely been reported. Nonetheless, it is a life-threatening emergency with high mortality and disability. We present a patient with an acute infarct due to a CAE during air travel. <h3>Design/Methods:</h3> NA <h3>Results:</h3> <h3>Case Report:</h3> A 67-year-old woman presents with two episodes of impaired consciousness during flights while in Europe. Both happened shortly after ascent. Her symptoms quickly resolved after an emergent landing on her first trip. During the second trip, however, symptoms recurred, and she remained unconscious. She was evaluated at a local hospital where a head computed tomography (CT) showed multiple cortical air locules, predominantly in the right hemisphere, consistent with cerebral air embolism. CT chest revealed a large left bulla with surrounding neovascularization, likely the cause of the embolism. A magnetic resonance imaging (MRI) brain confirmed numerous subacute infarcts across multiple vascular territories and diffuse white matter signal abnormality, consistent with the sequela of cerebral air embolism. She was transported to the US by sea for further management at a tertiary hospital, where she had successful resection of left lung bulla. She was subsequently discharged home with very mild left ataxia. <h3>Conclusions:</h3> Non-iatrogenic CAE is an extremely rare cause of ischemic stroke. Previously described cases relate to barometric pressure changes: during diving and ascent. We describe a patient presenting with CAE secondary to pulmonary shunt from a large lung bulla under barometric pressure changes during aircraft ascent. While literature suggests CAE as a life-threatening emergency with poor prognosis, this patient had an excellent outcome after surgical resection of the lung bulla, indicating possibly different outcomes between non-iatrogenic vs. iatrogenic CAE. <b>Disclosure:</b> Dr. Su has nothing to disclose. Dr. Pandya has nothing to disclose. Dr. Reyes has nothing to disclose. Dr. Shastry has nothing to disclose. Dr. Varade has nothing to disclose.