• Internal medicine · Jan 2012

    Case Reports

    Paradoxical cerebral air embolism occurred with postural change during rehabilitation, in a patient with ipsilateral internal carotid artery occlusion.

    • Kentaro Suzuki, Masayuki Ueda, Arata Abe, Yasuhiro Nishiyama, Seiji Okubo, Kenichiro Katsura, and Yasuo Katayama.
    • Division of Neurology, Department of Internal Medicine, Nippon Medical School Hospital, Japan. kentarow@nms.ac.jp
    • Intern. Med. 2012 Jan 1;51(9):1107-9.

    AbstractWe report a 76-year-old man with paradoxical cerebral air embolism. He developed consciousness disturbance and left hemiparesis after a postural change in rehabilitation. CT showed multiple air densities within the right hemisphere. An echocardiography showed a large right-to-left (RL) shunt. We considered the reason to be that a small amount of air entered, and the Valsalva-like maneuver with the postural change moved air into arterial circulation through the RL shunt and embolized a brain artery. The present case showed that even a small amount of air in the venous circulation may become a potential risk for cerebral air embolism, especially in the presence of a large RL shunt.

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