Paradoxical cerebral air embolism causing large vessel occlusion treated with endovascular aspiration. 2016

Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
Division of Neurosurgery, University of Missouri Columbia School of Medicine, Columbia, Missouri, USA.

Cerebral air embolism is a dreaded complication of invasive medical procedures. The mainstay of therapy for patients with cerebral air embolism has been hyperbaric oxygen therapy, high flow oxygen therapy, and anticonvulsants. We present a novel therapeutic approach for treatment of cerebral air embolism causing large vessel occlusion, using endovascular aspiration. Our patient developed a cerebral air embolism following sclerotherapy for varicose veins. This caused near total occlusion of the superior division of the M2 segment of the right middle cerebral artery. Symptoms included unilateral paralysis, unintelligible speech, and hemianopia; National Institutes of Health Stroke Scale (NIHSS) on presentation was 16. The air embolism was treated using a distal aspiration technique. Angiography following aspiration showed Thrombolysis in Cerebral Infarction 2B reperfusion. Following aspiration, the patient was re-examined; NIHSS at that time was 4. At 1 month follow-up, the modified Rankin Scale score was 1 and NIHSS was 1. Treatment of cerebral air embolism is discussed.

UI MeSH Term Description Entries
D008297 Male Males
D002533 Cerebral Angiography Radiography of the vascular system of the brain after injection of a contrast medium. Angiography, Cerebral,Angiographies, Cerebral,Cerebral Angiographies
D004618 Embolism, Air Blocking of a blood vessel by air bubbles that enter the circulatory system, usually after TRAUMA; surgical procedures, or changes in atmospheric pressure. Air Embolism,Embolism, Gas,Air Embolisms,Embolisms, Air,Embolisms, Gas,Gas Embolism,Gas Embolisms
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013396 Suction The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. Aspiration, Mechanical,Drainage, Suction,Aspirations, Mechanical,Drainages, Suction,Mechanical Aspiration,Mechanical Aspirations,Suction Drainage,Suction Drainages,Suctions
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D015901 Angiography, Digital Subtraction A method of delineating blood vessels by subtracting a tissue background image from an image of tissue plus intravascular contrast material that attenuates the X-ray photons. The background image is determined from a digitized image taken a few moments before injection of the contrast material. The resulting angiogram is a high-contrast image of the vessel. This subtraction technique allows extraction of a high-intensity signal from the superimposed background information. The image is thus the result of the differential absorption of X-rays by different tissues. Digital Subtraction Angiography,Subtraction Angiography, Digital
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D057510 Endovascular Procedures Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY. Endovascular Techniques,Intravascular Procedures,Intravascular Techniques,Endovascular Procedure,Endovascular Technique,Intravascular Procedure,Intravascular Technique,Procedure, Endovascular,Procedure, Intravascular,Procedures, Endovascular,Procedures, Intravascular,Technique, Endovascular,Technique, Intravascular,Techniques, Endovascular,Techniques, Intravascular

Related Publications

Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
January 2007, Internal medicine (Tokyo, Japan),
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
April 1971, The New England journal of medicine,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
April 2018, Journal of the American Heart Association,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
January 2008, Journal of intensive care medicine,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
May 2005, Heart (British Cardiac Society),
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
January 2017, Frontiers in neurology,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
October 2019, Der Nervenarzt,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
February 2022, Cureus,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
September 2022, Asian journal of neurosurgery,
Patrick J Belton, and Ashish Nanda, and Syeda L Alqadri, and Gurpreet S Khakh, and Premkumar Nattanmai Chandrasekaran, and Christopher Newey, and William E Humphries
July 2019, Journal of neurointerventional surgery,
Copied contents to your clipboard!