Experimental Cerebral Gas Embolism

Fries, Charles C.; Levowitz, Bernard S.; Adler, Sheldon; Cook, Albert W.; Karlson, Karl E.; Dennis, Clarence

doi:10.1097/00000658-195704000-00002

Cited by 82 publications

(28 citation statements)

References 3 publications

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“…The entry of gas into vessels was first described by Morgagni, whose post-mortem findings were published in 1769 [243,244]. The first clinical report dates to 1821 [244].…”

Section: Gas Embolismmentioning

confidence: 97%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

European Respiratory Journal

161

127

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Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes.The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than ''simple'' mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung.NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE.Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.

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“…The entry of gas into vessels was first described by Morgagni, whose post-mortem findings were published in 1769 [243,244]. The first clinical report dates to 1821 [244].…”

Section: Gas Embolismmentioning

confidence: 97%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

European Respiratory Journal

161

127

View full text Add to dashboard Cite

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“…This may be due in part to a threshold relation between these two measures, in that the brain may be able to tolerate small amounts of air, declining in function only after the entrainment of a threshold volume. 24 As such, an estimation of embolic volume may be more useful than incidence data in developing a cause and effect relation between neuropsychological deficits and cerebral air embolism.…”

Section: Detection and Volume Estimation Of Embolic Air In The Middlementioning

confidence: 99%

Detection and volume estimation of embolic air in the middle cerebral artery using transcranial Doppler sonography.

Bunegin

Wahl

Albin

1994

Stroke

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Background and Purpose Cerebral embolism has been implicated in the development of cognitive and neurological deficits following bypass surgery. This study proposes methodology for estimating cerebral air embolus volume using transcranial Doppler sonography.Methods Transcranial Doppler audio signals of air bubbles in the middle cerebral artery obtained from in vivo experiments were subjected to a fast-Fourier transform analysis. Audio segments when no air was present as well as artifact resulting from electrocautery and sensor movement were also subjected to fast-Fourier transform analysis. Spectra were compared, and frequency and power differences were noted and used for development of audio band-pass filters for isolation of frequencies associated with air emboli. In a bench model of the middle cerebral artery circulation, repetitive injections of various air volumes between 0.5 and 500 /iL were made. Transcranial Doppler audio output was band-pass filtered, acquired digitally, then subjected to a fast-Fourier transform power spectrum analysis and power spectrum inte-

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“…Se estableció el diagnóstico de embolismo gaseoso arterial cerebral e infarto agudo de miocardio secundario a embolismo gaseoso en arterias coronarias. Las primeras referencias de los embolismos gaseosos vasculares fueron recogidas en el tratado de Morgagni, publicado en 1769 1 . Existen dos tipos de embolismos gaseosos: venosos y arteriales, diferenciados por el mecanismo de entrada y órganos afectados.…”

Section: Embolismo Gaseoso Arterial Cerebral Y Coronariounclassified