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Pneumocephalus associated with massive cerebral air embolism
Jiu-Haw Yin1, Yi-Jung Chuang, Han-Hwa Hu
1Section of Neurology, Department of Medicine, Cheng-Hsin General Hospital Taipei, Taiwan.
Acta Neurologica Taiwanica
|September 14, 2013
Summary
A patient developed massive cerebral air embolism after aortic valve replacement surgery, leading to extensive brain infarction and coma. This rare complication highlights the risks associated with invasive vascular procedures.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Aortic valve replacement is a critical cardiac procedure.
- Postoperative complications can include pulmonary edema and respiratory distress.
- Invasive vascular procedures carry a risk of air embolism.
Observation:
- A 61-year-old man developed bilateral pneumothorax and remained comatose post-aortic valve replacement.
- Brain CT revealed massive cerebral air embolism with extensive infarction and mass effect.
- Air was observed in the carotid artery, cerebral arteries, and brain parenchyma.
Findings:
- The patient presented with anisocoric pupils and coma following mechanical ventilation and extracorporeal membrane oxygenation.
- Computed tomography (CT) demonstrated cerebral air embolism causing bilateral cerebral and cerebellar infarction.
- The imaging showed a peculiar pattern of air in the carotid artery, cerebral arteries, and parenchyma, suggesting blood-brain barrier breakdown.
Implications:
- Massive cerebral air embolism is a rare but devastating complication of cardiac surgery.
- This case underscores the importance of vigilance for air embolism in patients undergoing invasive vascular procedures.
- Understanding the imaging patterns of cerebral air embolism is crucial for diagnosis and management.
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