Introduction: Cerebral gas embolism is an unusual but extremely serious condition that occurs when air is introduced into the arterial or venous circulation of the brain. Although rare, it can lead to significant neurological deficits and even the death of the patient.
Clinical Case: 76-year-old patient with pre-existing diffuse interstitial lung disease, who experienced a massive stroke due to spontaneous pneumomediastinum. Her presentation included confusion, seizures, and motor weakness. Imaging tests revealed air bubbles in the cerebral sulci and hypodense areas in the cerebellum and parietooccipitals. In addition, pneumothorax and air in the upper mediastinum were noted on chest radiographs and chest CT scan. Despite therapeutic measures such as hyperbaric oxygen, the patient unfortunately died due to multiple organ failure.
Discussion: The diagnosis of cerebral gas embolism generally involves performing a cerebral computed tomography, which is highly sensitive for detecting the presence of air in the cerebral vessels. Management includes monitoring of vital and neurological signs, as well as specific measures such as airway closure, venous catheter aspiration, Trendelenburg positioning, and hyperbaric oxygen.
Conclusion: Cerebral gas embolism is a potentially fatal condition that requires a brain computed tomography for diagnosis and it is vitally important to know the prevention measures to avoid the appearance of this complication and also to know the general measures to adopt when it occurs.
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http://dx.doi.org/10.31053/1853.0605.v81.n2.42414 | DOI Listing |
JAMA Netw Open
January 2025
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.
Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).
Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.
Risk Manag Healthc Policy
January 2025
Department of Nursing, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People's Republic of China.
Purpose: The aim of this study is to examine the characteristics of intraoperative nursing near-miss events in interventional operating rooms, systematically identify and analyze associated risks, and propose effective mitigation strategies.
Patients And Methods: A retrospective study was conducted using a specially designed survey focused on nursing near-miss events in Interventional operating rooms. Records of intraoperative near-miss events voluntarily reported by medical and nursing staff between January 2023 and March 2024 were analyzed.
Eur Spine J
January 2025
Department of Orthopedic, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei, Taiwan.
Purpose: Spine surgery, particularly deformity correction, is associated with a high risk of peri-operative or post-operative complications, and these complications can lead to catastrophic consequences. This case report will present the etiology and treatment process of the peri-operative cardiac arrest during scoliosis correction surgery.
Method: In this report, we present a case of cardiac arrest during posterior correction surgery in a 17-year-old female patient with adolescent idiopathic scoliosis.
Med Klin Intensivmed Notfmed
January 2025
University Heart Center Lübeck, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Background: Pulmonary arterial embolism (PE) is not well characterized in elderly patients. In addition, unnecessary computed tomography pulmonary angiography (CTPA) examinations are often performed within this patient group, especially if the pretest probability is low.
Objective: To identify differences in clinical presentation in patients aged ≥80 years compared to patients <80 years and the effect of a BGA-optimized pretest probability to reduce unnecessary CTPAs according to age category.
Med Gas Res
June 2025
Department of Hyperbaric Oxygen, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Common cardiovascular surgeries include coronary artery bypass grafting, cardiac valve replacement, radiofrequency ablation, and cardiac intervention surgery. Multiple postoperative complications, such as hypoxic encephalopathy, air embolism, retained intracardiac air, cognitive dysfunction and major adverse cardiovascular events, including heart failure, ischemic stroke, and myocardial infarction, may occur after these cardiovascular surgeries. Hyperbaric oxygen can be used in preconditioning to lower the morbidity of adverse complications.
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