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Cerebral Venous Air Embolism Secondary to Mesenteric Infarction
Ittikorn Spanuchart1, Aileen Tamura1, Brent Matsuda1
1University of Hawai'i Internal Medicine Residency Program, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
Summary
This case study details a rare instance of cerebral venous air emboli originating from the hepatic portal system due to mesenteric infarction. This unusual retrograde embolism highlights a previously unreported pathway for air to reach the brain.
Area of Science:
- Medicine
- Radiology
- Gastroenterology
Background:
- Cerebral air embolism is a rare but life-threatening condition.
- Retrograde cerebral venous air embolism is an exceptionally uncommon presentation.
Observation:
- A 69-year-old male with a history of gastrointestinal amyloidosis presented with fever and lethargy.
- CT scans revealed cerebral venous air emboli and signs of mesenteric infarction with intrahepatic portal venous air.
Findings:
- The patient exhibited retrograde cerebral venous air emboli originating from the hepatic portal venous system.
- This was secondary to mesenteric infarction leading to extensive intrahepatic portal venous air.
- The air likely ascended via the vena cava to the cerebral venous system.
Implications:
- This case represents the first reported instance of retrograde cerebral venous air embolism from the hepatic portal system secondary to mesenteric infarction.
- The clinical significance and prognosis of this specific pathway require further investigation.
- This finding may prompt reevaluation of diagnostic and treatment strategies for similar complex cases.
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