Persistent Air Embolism after Blunt Chest Trauma with Recovery to Pre-Existing Consciousness Level: A Case Report and Literature Review

Soh, Mitsuhito; Hifumi, Toru; Isokawa, Shutaro; Iwasaki, Tadaaki; Otani, Norio; Ishimatsu, Shinichi

doi:10.1089/neur.2021.0052

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…Paradoxical embolization from the venous system 10 Central venous catheter placement, malfunction, or removal 7,10,11 Percutaneous lung needle biopsy 12 Neurosurgical procedures 13 Chest, head, and neck trauma 14,15 Head and neck trauma Cardiopulmonary resuscitation 16 Hydrogen peroxide irrigation during surgery [17][18][19] Positive pressure ventilation 20 Hemodialysis [21][22][23] Mechanical thrombectomy 24 Cardiac catheterization and cardioverter placement 21 Cardiopulmonary bypass 25 Arterial line ushing 26…”

Section: Caae Etiologies Cvae Etiologiesmentioning

confidence: 99%

Cerebral Air Embolism: Neurologic Manifestations, Prognosis and Outcome

Červeňák,

Všianský,

Cviková

et al. 2024

Preprint

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Background Cerebral air embolism (CAE) is an uncommon medical emergency with a potentially fatal course. We have retrospectively analyzed a set of patients treated with CAE at our comprehensive stroke center and a hyperbaric medicine center. An overview of the pathophysiology, causes, diagnosis, and treatment of CAE is provided. Methods We retrospectively identified 11 patients with cerebral venous and arterial air emboli that highlight the diversity in etiologies, manifestations, and disease courses encountered clinically. Results Acute-onset stroke syndrome and a progressive impairment of consciousness were the two most common presentations in 4 patients each (36%). Two patients (18%) suffered from an acute-onset coma, and one (9%) was asymptomatic. Four patients (36%) were treated with hyperbaric oxygen therapy (HBTO), high-flow oxygen therapy without HBOT was started in two patients (18%), two patients (18%) were in critical care at the time of diagnosis and three (27%) received no additional treatment. CAE was fatal in five cases (46%), caused severe disability in two (18%), mild disability in three (27%), and a single patient had no lasting deficit (9%). Conclusions CAE is a dangerous condition that necessitates high clinical vigilance. Due to its diverse presentation, the diagnosis can be missed or delayed in critically ill patients and result in long-lasting or fatal neurological complications. Preventative measures and a proper diagnostic and treatment approach reduce CAE’s incidence and impact.

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Section: Caae Etiologies Cvae Etiologiesmentioning

confidence: 99%

Cerebral Air Embolism: Neurologic Manifestations, Prognosis and Outcome

Červeňák,

Všianský,

Cviková

et al. 2024

Preprint

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“…AE is difficult to diagnose in the acute phase as the embolus disappears in about 0.5-30h. [1] Diagnosis is usually made with imaging tests. The treatment of air embolism is eminently supportive.…”

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confidence: 99%

Arterial Air Embolism Due to Blunt Chest Trauma: A Case Report

Almeida¹,

Lopes²,

Tenani³

et al. 2022

ijSciences

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Trauma is the third leading cause of death in Brazil and has a huge impact on the potential years of life lost. Most of the lesions identified are mild and, when treated in time have an excellent prognosis. Air embolism (AE) is a rare but potentially fatal condition, especially after blunt chest trauma, when diagnosis is challenging. A 39-year-old male victim of a motorcycle fall at 60 km/h with moderate traumatic brain injury and chest trauma. There was no change in the primary assessment. In the secondary evaluation, he presented pain on palpation of the anterior chest, and pain in the epigastrium, without peritonitis. The computed tomography (CT) demonstrated the presence of a gaseous focus in the left ventricle (LV); small bilateral pneumothorax foci; areas of lung contusion bilaterally; left kidney and pancreas with signs of ischemia and gaseous foci inside. He was followed in the Intensive Care Unit (ICU) with acute renal failure and pancreatitis, treated conservatively. Then, he was undergone to a cardiac catheterization: absence of significant obstructive coronary artery disease and mild LV systolic dysfunction. He was maintained on 100% O2 until discharge from the ICU and discharged from hospital after 12 days of hospitalization. When the lung parenchyma is injured by a blunt trauma of high kinetics, the pulmonary vessels (PV) and the bronchial tree come into contact and air, under high pressure, enters the PV causing AE. AE is difficult to diagnose in the acute phase as the embolus disappears in about 0.5-30h. [1] Diagnosis is usually made with imaging tests. The treatment of air embolism is eminently supportive. 100% O2 therapy decreases bubble size by forcing nitrogen out of the plunger. The use of a hyperbaric chamber is described and, in more severe cases, it is possible to perform aspiration of the ventricle.

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Persistent Air Embolism after Blunt Chest Trauma with Recovery to Pre-Existing Consciousness Level: A Case Report and Literature Review

Cited by 2 publications

References 28 publications

Cerebral Air Embolism: Neurologic Manifestations, Prognosis and Outcome

Cerebral Air Embolism: Neurologic Manifestations, Prognosis and Outcome

Arterial Air Embolism Due to Blunt Chest Trauma: A Case Report

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