[Retrograde cavernous sinus air embolism after central venous catheter removal]

Air embolism is a rare, but occasionally fatal complication of peripheral and central venous catheterization. We present a case of an 89-year-old female, who had a central venous catheter placed in her right jugular vein during the perioperative period for right femoral subtrochanteric fracture. On the day following her operation, level of consciousness worsened a few minutes after the catheter was removed. CT scan showed air bubbles in bilateral cavernous sinuses and brachiocephalic vein. Administration of 100% oxygen was started, and she regained consciousness a few hours later, finally air bubbles disappeared on a CT scan performed 10 hours after onset. Air embolism should be taken into consideration when treating venous catheters, and appropriate O₂ administration and radiological examinations must be performed immediately if level of consciousness or vital signs deteriorate.