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Cerebral venous air embolism treated with hyperbaric oxygen: a case report
Pieter A Bothma1, Andreas E Brodbeck, Bruce A Smith
1Department of Anaesthesia, James Paget University Hospitals NHS Foundation Trust, Norfolk, UK. pabothma@dsl.pipex.com
Abstract:
We present a case of cerebral venous gas embolism. Our patient made a complete neurological recovery after hyperbaric oxygen therapy (HBOT). The principles of HBOT, compressing and eliminating air bubbles and decreasing Β-2 integrin function, thus improving microcirculation, can only be beneficial in a situation where neurological damage is likely. Retrograde cerebral venous gas embolism is a less well recognised variant of gas embolism than the arterial variant. Its existence as a different entity is better recognised in the forensic medicine and radiology literature than in other disciplines. There is evidence in the literature of patients dying from this complication and others seemingly experiencing very little effect. This case report highlights this condition, to encourage others to look out for it and report outcomes, and to serve as a reminder that peripheral lines may be a potential cause of gas embolism, although the portal of air entry in our case remains uncertain.
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