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Cerebral air embolism

Case contributed by Dr Huda B. Gharbia

Presentation

Respiratory distress and loss of consciousness following a prolonged surgery for a right lower limb gunshot wound

Patient Data

Age: 25 years
Gender: Male
CT

Brain CT with contrast revealing evidence of serpiginous air densities in sulci of the parietal and occipital lobes of both cerebral hemispheres.

The patient admitted to ICU for mechanical ventilation due to respiratory failure and hemodynamic instability. A follow-up brain CT was performed after 24 hours.

CT

Follow up brain CT non- contrast study performed 24 hours after reveals hypodensities in both cortical and subcortical regions of both cerebral hemispheres. This indicate multiple cortical infarctions and brain edema with sign of transtentorial herniation. 

Case Discussion

The patient demonstrates a massive cerebral air embolism. The exact cause is unknown; however, multiple venous lines were present.  Air densities in sulci rapidly resolved and multiple cerebral infarctions and brain edema  developed.

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Case information

rID: 60600
Published: 28th May 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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