Retrograde Cerebral Air Embolism Associated With Bronchovenous Fistula

Cerebral air embolism is a rare event and predominantly iatrogenic. Here we present a case of spontaneous intravascular cerebral air embolism caused by lung cancer, which is among the other previously reported cases worldwide. A 69-year-old man with small cell lung carcinoma presented after being found unconscious. Computed tomography (CT) of the chest revealed a lung mass eroding into the superior vena cava (SVC) and with communication to the right upper lobe bronchus. As the patient's neurologic status deteriorated further, serial CT scans of the brain noted multiple air emboli with development of left cerebral infarction, and death followed shortly after. This case highlights the rapid progression of this rare condition and thereby the need to be familiar with the clinical setting in which the presence of cerebral air embolism can occur.