Paradoxical air embolism during neurosurgery

Four cases of air embolism which occurred during neurosurgical procedures in the sitting position are described, in whom the signs could be due to air in the coronary or cerebral arteries. It is suggested that, during venous air embolism in the sitting position, a significant number of patients are haemodynamically at risk from paradoxical air embolism, and that the serious consequences of venous air embolism in neurosurgery may be due to this.