A 50-year-old woman who underwent double-lung transplantation suffered a massive cerebral air embolism with severe neurological impairment and temporary hemodynamic deterioration after surveillance bronchoscopy and central line removal. We hypothesize that this was due to microscopic pulmonary parenchymal injury during bronchoscopy as well as air entrainment during removal of the central venous line, with subsequent transpulmonary passage into the cerebral vessels.
ShettyPGFatterpekarGMManoharSSujitVVarshaJZarirU. Fatal cerebral air embolism as a complication of transbronchoscopic lung biopsy: a case report. Australas Radiol2001;45:215–7.
2.
WherrettCGMehranRJBeaulieuMA. Cerebral arterial gas embolism following diagnostic bronchoscopy: delayed treatment with hyperbaric oxygen. Can J Anaesth2002;49:96–9.
3.
BrounsRDe SurgelooseDNeetensIDe DeynPP. Fatal venous cerebral air embolism secondary to a disconnected central-venous catheter. Cerebrovasc Dis2006;21:212–4.
4.
MuthCMShankES. Gas embolism [Review]. N Engl J Med2000;342:476–82.
5.
TommasinoCRizzardiRBerettaLVenturinoMPiccoliS. Cerebral ischemia after venous air embolism in the absence of intracardiac defects. J Neurosurg Anesthesiol1996;8:30–4.
6.
EdmondsCRBarbutDHagerDSharrockNE. Intraoperative cerebral arterial embolization during total hip arthroplasty. Anesthesiology2000;93:315–8.
7.
PrasadABanerjeeSBrilakisES. Images in cardiovascular medicine. Hemodynamic consequences of massive coronary air embolism. Circulation2007;115(30):e51–3.
