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Cerebral Ischemia After Venous Air Embolism in the Absence of Intracardiac Defects

 

作者: Concezione Tommasino,   Roberto Rizzardi,   Luigi Beretta,   Marco Venturino,   Susanna Piccoli,  

 

期刊: Journal of Neurosurgical Anesthesiology  (OVID Available online 1996)
卷期: Volume 8, issue 1  

页码: 30-34

 

ISSN:0898-4921

 

年代: 1996

 

出版商: OVID

 

关键词: Complication;Cerebral ischemia;Embolism;Venous air embolism

 

数据来源: OVID

 

摘要:

Cerebral air embolism occurred in a patient undergoing posterior fossa surgery performed in the sitting position for acoustic neuroma removal. The patient experienced two episodes of venous air embolism, as evidenced by precordial Doppler, end-tidal carbon dioxide reduction, and oxygen desaturation. In both cases, air was aspirated from the central venous catheter; during the second episode there was arterial hypotension and electrocardiogram changes, and air bubbles were visualized in the cerebellar arteries. The patient did not regain consciousness after surgery and developed early tonic-clonic convulsions and electroencephalogram status epilepticus, which was treated with barbiturate coma. Intracardiac septal defects were not detected by trans-esophageal echocardiography, and computerized tomography of the brain demonstrated multifocal discrete ischemic areas in the cerebral hemispheres. The patient died 6 days after surgery without having regained consciousness. This case appears to represent the occurrence of transpulmonary passage of venous air embolism.

 

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