• Rev Neurol France · Aug 2011

    Case Reports

    [Iatrogenic venous cerebral air embolism without pulmonary manifestation: A retrograde mechanism?].

    • N Raposo, F Faiz, J-F Albucher, E Dugert, F Bonneville, P Meliani, and F Chollet.
    • Service de neurologie vasculaire, hôpital Purpan, pavillon Riser, CHU de Toulouse, 31059 Toulouse cedex 3, France. raposo.n@chu-toulouse.fr
    • Rev Neurol France. 2011 Aug 1;167(8-9):615-8.

    IntroductionAir embolism is a rare complication of various invasive medical procedures. Venous cerebral air embolism is usually the consequence of paradoxical embolism. We report a case of isolated cerebral air embolism resulting from a non-paradoxical mechanism.Case ReportA few minutes after his central venous catheter had been accidentally disconnected, a 63-year-old man developed left-sided rhythmic jerking movements followed by left hemiplegia. There were no associated cardiologic or pulmonary signs. Brain CT showed air bubbles in the right frontal cortical sulci. The brain MRI DWI and FLAIR sequences showed a high intensity right frontal cortical lesion without reduction in ADC. Transesophageal echocardiogram did not find a patent foramen ovale.ConclusionsIn this case of venous cerebral air embolism, the lack of any cardiopulmonary manifestation, the lack of a patent foramen ovale and the neuroradiological findings are not in favor of the hypothesis of paradoxical embolism. The hypothesis of retrograde venous cerebral air embolism is discussed.Copyright © 2010 Elsevier Masson SAS. All rights reserved.

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