Cerebral air embolism

Dr Henry Knipe et al.

Cerebral air embolism is rare but can be fatal. They may be venous or arterial and are often iatrogenic in cause. 

Presentation is often varied and non-specific but include confusion, motor weakness, decreased consciousness, seizure and vision loss. 

Cerebral air embolism can be within the arterial or venous systems. Air can enter both systems directly or cause paradoxical embolus with a venous air embolus entering the arterial system via a right-to-left shunt. 

  • arterial: trauma, surgery (especially cardiothoracic/neurosurgery), procedures (e.g. arterial line, lung biopsy)
  • venous: central venous catheter placement/removal; IV contrast injection into peripheral line

Cerebral air emboli can act like thrombotic emobli and cause end-artery occlusion and ischaemic stroke. Cerebral oedema can also develop. 

  • may only be diagnostic in the acute setting as gas is absorbed rapidly 4
  • use of lung windows may help increase detection

Treatment is typically supportive although there is increasing evidence for the use of hyperbaric oxygen therapy. 

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Article information

rID: 32536
Section: Pathology
Synonyms or Alternate Spellings:
  • Cerebral air emboli

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