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Diffuse cerebral air embolism treated with hyperbaric oxygen: a case report.

Martin J Fowler1, Carole E Thomas, Robert A Koenigsberg

  • 1Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania, USA.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|December 3, 2004
PubMed
Summary

A cardiac procedure complication led to acute stroke due to cerebral air emboli. Prompt hyperbaric oxygen therapy and supportive care resulted in a full neurological recovery.

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Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • A 54-year-year-old woman underwent cardiac evaluation for atypical chest pain.
  • Coronary angiography and left ventriculography were performed as part of the workup.

Observation:

  • Inadvertent air injection during left ventriculography caused acute right hemisphere syndrome.
  • Initial imaging revealed right hemispheric edema, progressing to diffuse bilateral parietal lobe edema on MRI.
  • The patient experienced a seizure after initial hyperbaric oxygen therapy, leading to its discontinuation.

Findings:

  • Cerebral air emboli were suspected as the cause of the acute neurological deficit.
  • Hyperbaric oxygen therapy was initiated within 60 minutes of symptom onset.
  • Follow-up MRI at 6 months showed complete resolution of edema, with a normal neurological examination.

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Implications:

  • This case highlights the potential for iatrogenic cerebral air embolism during cardiac procedures.
  • Early recognition and intervention, including hyperbaric oxygen therapy, may be crucial for neurological recovery.
  • Complete neurological recovery is possible despite initial severe imaging findings.