Involvement of Jugular Valve Insufficiency in Cerebral Venous Air Embolism

Nedelmann, Max; Pittermann, P.; Gast, Klaus; Mueller-Forell, Wibke; Dieterich, Marianne

doi:10.1111/j.1552-6569.2006.00073.x

Cited by 21 publications

(9 citation statements)

References 7 publications

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“…Retrograde rise of air bubbles against the venous blood flow is a mechanism described previously in literature, commonly following venous vascular intervention and there is speculation that its prevalence is underestimated [9] . It has also been suggested that jugular valve insufficiency can predispose to retrograde embolism in the neck, but this was not demonstrated on ultrasound of the neck in our case [11] .…”

Section: Discussioncontrasting

confidence: 75%

A case of retrograde venous air embolism causing cerebral infarction following upper gastrointestinal endoscopy: A novel pathophysiological mechanism

Uldin

Shabana

Raslan

2018

Radiology Case Reports

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The incidence of cerebral infarction following upper gastrointestinal endoscopic procedures is well described in the existing literature, with most mechanisms involving arterial travel of the embolus. We describe a case of cerebral infarction not explained by previously described mechanisms and detail the proposed occurrence of retrograde venous air embolism causing cerebral infarction following an upper gastrointestinal endoscopic procedure.

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Section: Discussioncontrasting

confidence: 75%

A case of retrograde venous air embolism causing cerebral infarction following upper gastrointestinal endoscopy: A novel pathophysiological mechanism

Uldin

Shabana

Raslan

2018

Radiology Case Reports

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“…Among the published cases of cerebral venous air embolism related to central catheter use, air was most frequently demonstrated in the cortical veins [ 30–33 ] and the cavernous sinuses [ 33–36 ]. Moreover, air emboli involving the cavernous sinuses [ 37–40 ] and the jugular veins [ 39 , 40 ] have also been reported after peripheral bloodline manipulations. Normally the valves in the jugular vein ensure unidirectional blood flow towards the heart.…”

Section: Pathophysiology and Clinical Manifestationsmentioning

confidence: 99%

Venous air embolism related to the use of central catheters revisited: with emphasis on dialysis catheters

Wong¹,

Kwaan²,

Ing³

2017

Clinical Kidney Journal

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Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures. The not-that-uncommon occurrence of venous air embolism, often precipitated by improper patient positioning during cervical catheter procedures, suggests that awareness of this procedure-related complication among health care workers is not universal. This review aims to update the pathophysiology of venous air embolism and to emphasize the importance of observing the necessary precautionary measures during central catheter use in hopes of eliminating this unfortunate but easily avoidable mishap in nephrology practice.

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“…It was reported that air bubbles can cause cerebral venous embolism by retrograde flow in patients with central venous catheters depending on bubble volume, blood flow velocity, superior vena cava diameter and cardiac output 8 . Absence or insufficiency of valves in the jugular vein were presumed to be the cause for retrograde embolism 9 . External cardiac resuscitation was speculated to cause retrograde cerebral venous air embolism due to increased intrathoracic pressure 10 .…”

Section: Discussionmentioning

confidence: 99%

Pneumocephalus in a patient with multiple stab wounds

Savran

Karaçam

Bayram

et al. 2017

Turkish Journal of Emergency Medicine

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Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse. Brain computerized tomography demonstrated free air in intracranial and extracranial venous structures. Pneumocephalus was diagnosed which may be due to a wide spectrum of etiologies including thorax or spinal stab wounds, tube thoracostomy, cardiopulmonary resuscitation or even central venous catheterization. Unfortunately, the patient ended up with brain death despite all effort. In conclusion, we recommend physicians to be aware of this catastrophic complication while taking care of patients with stab wounds.

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Involvement of Jugular Valve Insufficiency in Cerebral Venous Air Embolism

Abstract: This case report gives insight into the mechanism of cerebral venous air embolism. This is the firstcase describing jugular valve insufficiency as the missing link between peripheral air embolism and cerebral venous air entrapment.

Cited by 21 publications

References 7 publications

A case of retrograde venous air embolism causing cerebral infarction following upper gastrointestinal endoscopy: A novel pathophysiological mechanism

A case of retrograde venous air embolism causing cerebral infarction following upper gastrointestinal endoscopy: A novel pathophysiological mechanism

Venous air embolism related to the use of central catheters revisited: with emphasis on dialysis catheters

Pneumocephalus in a patient with multiple stab wounds

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