Cerebral air embolism associated with penetrating lung injury: a case report and review of the literature

Acute Medicine & Surgery
Ayumu YamaokaNaoya Yama

Abstract

A 44-year-old man intentionally stabbed himself in the anterior neck and left thorax with a fruit knife. Physical examination revealed two open wounds entering the thoracic cavity in the front chest, and a stab wound entering the trachea at the neck. Two chest tubes were initially inserted for the left lung injury with open hemopneumothorax. Nevertheless, the worsening oxygenation required positive pressure ventilation (PPV) with endotracheal intubation. Right hemiparesis was found during weaning from PPV. Magnetic resonance imaging revealed multiple infarctions in the area of the bifrontal and right temporal lobes. Cerebral air embolism (CAE) was strongly suspected from the imaging findings and clinical course. We concluded that mechanical ventilation was strongly involved in the occurrence of CAE. If delayed abnormal neurological findings are observed in patients with penetrating lung injuries receiving PPV management, CAE should be considered.

References

Feb 10, 1999·Anesthesiology·A M Ho, E Ling
Nov 13, 2001·Journal of Neurosurgery·I Sakai, S Nishizawa
Apr 17, 2007·Cerebrovascular Diseases·Sang-Beom JeonSun Uck Kwon
Mar 1, 2008·Journal of the American College of Surgeons·Federico Milla, Mitchell Cahan
Mar 25, 2011·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jörg BrederlauThomas Wurmb
May 3, 2012·The Thoracic and Cardiovascular Surgeon·Emeka KesiemeGeorgi Prisadov

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Citations

Dec 27, 2017·The American Journal of Forensic Medicine and Pathology·Isabella MercurioMario Gabbrielli

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Methods Mentioned

BETA
sedation

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