Cerebral air embolism
Updates to Article Attributes
Cerebral air embolism is rare but can be fatal. They may be venous or arterial and are often iatrogenic in cause.
Clinical presentation
Presentation is often varied and non-specific but include confusion, motor weakness, decreased consciousness, seizure and vision loss.
Pathology
Cerebral air embolism can be within the arterial or venous systems. Air can enter both systems directly or cause paradoxical embolus with a venous air embolus entering the arterial system via a right-to-left shunt.
Aetiology
- arterial: trauma, surgery (especially cardiothoracic/neurosurgery), procedures (e.g. arterial line, lung biopsy)
- venous: central venous catheter placement/removal; IV contrast injection into peripheral line
Complications
Cerebral air emboli can act like thrombotic emboli and cause end-artery occlusion and ischaemic stroke. Cerebral oedema can also develop.
Radiographic features
The distribution of air is variable and extensive cerebral infraction, often in a watershed distribution, maybe the only visible change.
CT
- may only be diagnostic in the acute setting as gas is absorbed rapidly 4
- use of lung windows may help increase detection
MRI
MRI is primarily used to evaluate the complications of cerebral air embolism (infarction) rather than to detect the air directly.
Treatment and prognosis
Treatment is typically supportive although there is increasing evidence for the use of hyperbaric oxygen therapy.
-</ul><h5>Complications</h5><p>Cerebral air emboli can act like thrombotic emboli and cause end-artery occlusion and <a href="/articles/ischaemic-stroke">ischaemic stroke</a>. <a href="/articles/cerebral-oedema-1">Cerebral oedema</a> can also develop. </p><h4>Radiographic features</h4><p>The distribution of air is variable and extensive <a title="Cerebral infarction" href="/articles/ischaemic-stroke">cerebral infraction</a>, often in a <a title="Watershed cerebral infarction" href="/articles/watershed-cerebral-infarction">watershed distribution</a>, maybe the only visible change. </p><h5>CT</h5><ul>- +</ul><h5>Complications</h5><p>Cerebral air emboli can act like thrombotic emboli and cause end-artery occlusion and <a href="/articles/ischaemic-stroke">ischaemic stroke</a>. <a href="/articles/cerebral-oedema-1">Cerebral oedema</a> can also develop. </p><h4>Radiographic features</h4><p>The distribution of air is variable and extensive <a href="/articles/ischaemic-stroke">cerebral infraction</a>, often in a <a href="/articles/watershed-cerebral-infarction">watershed distribution</a>, maybe the only visible change. </p><h5>CT</h5><ul>
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