[A 69-year-old man with temporary left-sided hemiparesis]
Kristin Lif Breivik1, Erik Waage Nielsen
1Nevrologisk avdeling, Sentralsjukehuset i Sogn og Fjordane, 6807 Førde. kristinlif@hotmail.com
Summary
A disconnected central venous catheter (CVC) can cause a stroke due to air entering the brain. Immediate CVC securing and patient positioning are crucial to prevent this serious complication.
Area of Science:
- Neurology
- Vascular Surgery
- Critical Care Medicine
Background:
- Central venous catheters (CVCs) are common medical devices.
- Disconnection of CVCs can lead to serious complications.
- Air embolism is a known risk associated with CVCs.
Observation:
- A 69-year-old man experienced left-sided hemiparesis within a minute of accidentally disconnecting his CVC.
- The neurological deficit resolved within 30 minutes.
- A subsequent brain CT scan was normal.
Findings:
- The patient's symptoms are consistent with a transient ischemic attack (TIA).
- Cerebral air embolism from the disconnected CVC is the suspected cause of the TIA.
- Possible mechanisms include paradoxical embolism via intracardiac shunts or retrograde passage into the cerebral venous system.
Implications:
- This case highlights the risk of cerebral air embolism from CVCs, even in ambulatory patients.
- Recommendations for managing suspected air embolism include securing the CVC, placing the patient in a recumbent position, administering 100% oxygen, and considering hyperbaric oxygen therapy.
- Emphasizes the importance of patient positioning during CVC insertion and maintenance to mitigate risks.
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