An unusual cause of ischemic stroke - Cerebral air embolism

Suri, Vinit; Gupta, Rohan; Sharma, Gajendra; Suri, Kunal

doi:10.4103/0972-2327.128562

Cited by 20 publications

(12 citation statements)

References 11 publications

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“…Practically any form of medical treatment is associated with some risk of adverse events. Iatrogenic cerebral gas embolism (ICGE) occurs when gas enters the cerebral circulation in relation to a medical procedure, and may lead to vascular occlusion or local irritation . It is a known complication of a variety of procedures in clinical practice, and a broad range of symptoms has been reported .…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic cerebral gas embolism–A systematic review of case reports

Hatling

Høgset

Guttormsen

et al. 2018

Acta Anaesthesiol Scand

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Section: Introductionmentioning

confidence: 99%

Iatrogenic cerebral gas embolism–A systematic review of case reports

Hatling

Høgset

Guttormsen

et al. 2018

Acta Anaesthesiol Scand

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“…placement of central venous line), and trauma. Typical cases result in impairment of the cardiovascular, pulmonary, and central nervous systems [ 2 ]. Specifically in cardiac bypass procedures, massive air embolism is a very rare event but with adverse outcomes in 50% [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Air Embolism into Superior Mesenteric Artery Following Replacement of Ascending Aorta for Aortic Dissection – A Rare and Fatal Case

Lambert

Grus

Špunda

et al. 2018

Journal of the Belgian Society of Radiology

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We report an unusual case of fatal air embolism into the superior mesenteric artery in a patient, who underwent replacement of the ascending aorta for aortic dissection type A. CT performed twice on the first postoperative day showed abundant air in the superior mesenteric artery and its branches (but not in the portal-venous system) indicating air embolism with no signs of bowel necrosis. On the second postoperative day, the patient underwent extensive bowel resection due to bowel ischemia and died on the third postoperative day on MODS/SIRS.

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“…Im akuten Zustand ist dies aufgrund der Unkoordiniertheit der Tiere und der bestehenden Ataxie als zu gefährlich einzustufen. Eine computertomographische Untersuchung des Gehirns war aufgrund der notwendigen Sedation und Narkose in den vorliegenden Fällen ebenso als zu komplikationsreich anzusehen (Walsh et al 2005, Gunew et al 2008, Pellegrini-Masini et al 2009, Heng et al 2014, Suri et al 2014, Reith et al 2015. Zusammenhang mit der vorangegangen Thorakoskopie nicht auszuschließen, allerdings wurden in der Literatur bei ähn-lichen Eingriffen solche Komplikationen nicht beobachtet (Scharner 2012).…”

Section: Patientunclassified

Clinical presentation and short-term outcome in two horses with suspected air embolism

Gittel¹,

Delling²,

Brehm³

et al. 2016

PHK

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Complications associated with intravenous catheters have been reported frequently and are not only limited to thrombophlebitis of the respective vessel. There are some reports of air embolism in small and large animals described in the literature. The source of air aspiration can be traumatic, iatrogenic during surgeries and also related to venous catheters. Not only the reason for air aspiration, but also the consequences differ between human, small animals and horses. This present article describes the clinical signs, treatment and short-term outcome of two horses with suspected venous air embolism but with different underlying diseases. Both horses exhibited a sudden onset of cardiovascular shock and periods of neurological disorder during their hospitalization. One horse also showed colic symptoms. In both horses an inadvertently opened venous catheter was found at the onset of unexpected symptoms. Therefore, air embolism due to air aspiration by the open venous access might be possible. In air embolism, a decreased perfusion and reduced oxygen delivery are potential sequelae. An impairment of the cardiovascular system with subsequent cerebellar hypoperfusion and embolism might be an explanation for the observed clinical signs. These were tachycardia, delayed capillary refill time and excitement. Furthermore, ataxia, seizures and blindness was observed. Intensity and duration of clinical signs differed between both horses. Following supportive treatment, both horses were discharged from hospital in a good condition. The exact amount of air leading to clinical signs is not exactly known despite different studies aiming at finding a lethal dose. However, rate and amount of air aspiration, as well as body weight and health status of the patient may also have an effect on occurrence of overt clinical signs of venous air embolism. Due to the lack of specific treatment options, symptomatic therapy has been performed. This includes intravenous fluid administration for cardiovascular stabilization and anti-inflammatory treatment. Additionally, nasal oxygen insufflations may increase tissue oxygenation. Furthermore, neuroprotectiv treatment, like dexamethason, might also be advantageous regarding the pathophysiology of venous and cerebellar air embolism. Antithrombotic treatment can be initiated in order to avoid formation of thrombus following capillary perfusion disturbances in the circulation. Diagnostic proof is lacking in both cases, however, presence of an open venous catheter and the observed clinical signs lead to the suspected diagnosis of venous air embolism. Venous air embolism seems to have a low incidence in equine medicine, and the exact dimension of clinical signs may not always be obvious. Close attention should be paid at infusion lines, air within syringes, disconnection of catheters and their extensions and catheter caps. Problems may occur due to manipulations by the horse itself or due to improper handling by the attending veterinarian. Several medical devices aim at reducing the risk of air aspi...

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An unusual cause of ischemic stroke - Cerebral air embolism

Cited by 20 publications

References 11 publications

Iatrogenic cerebral gas embolism–A systematic review of case reports

Iatrogenic cerebral gas embolism–A systematic review of case reports

Air Embolism into Superior Mesenteric Artery Following Replacement of Ascending Aorta for Aortic Dissection – A Rare and Fatal Case

Clinical presentation and short-term outcome in two horses with suspected air embolism

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