Cerebral air embolism
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Cerebral air embolism is rare but can be fatal. They may be venous or arterial and are often iatrogenic.
Presentation is often varied and non-specific but includes confusion, motor weakness, decreased consciousness, seizure, and loss of vision.
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.
surgery (especially cardiothoracic/neurosurgery)
procedures, e.g. arterial line, lung biopsy
central venous catheter placement or removal
IV contrast injection into a peripheral line
may only be diagnostic in the acute setting as gas is absorbed rapidly 4
use of lung windows may help increase detection
MRI is primarily used to evaluate the complications of cerebral air embolism (infarction) rather than to detect the air directly.
Treatment and prognosis
Treatment is typically supportive although there is increasing evidence for the use of hyperbaric oxygen therapy.
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