Cerebral Air Embolism Causing Cerebrovascular Accident after CT-Guided Needle Lung Biopsy

A CT-guided lung biopsy is a procedure to obtain tissue samples for lesion characterization and staging, but a rare and dangerous complication is a cerebral and systemic air embolism, which can cause ischemic organ damage.

We report a case of a 62-year-old male with adenocarcinoma of the right lung who underwent a CT-guided lung biopsy to assess for small cell transformation. During the final biopsy attempt, a suctioning sound was heard from the needle tip, and the patient immediately became unresponsive, experiencing hypotension, tachycardia, and hypopnea. Non-contrast CT showed intracranial and subcutaneous air emboli. The patient was intubated and transferred to the ICU, where he received hyperoxygenation therapy.

This case highlights that cerebral air embolism, although rare, can be a severe complication of CT-guided lung biopsy. Prompt recognition and treatment are essential for positive outcomes. As image-guided procedures increase, such cases may become more common, requiring further research.