| Cerebral air embolism after arthrography of the ankle. | |
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MedLine Citation:
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PMID: 20581782 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The accidental migration of air from the venous circulation into the systemic arterial circulation is called paradoxical air embolism. This is a potential disastrous complication after diagnostic and surgical procedures. Arthrography has been a useful technique in joint imaging for the past decades. Paradoxical cerebral air embolism is a very rare complication, only a few cases have been reported after arthrography of the hip in children. Here, we describe a patient with progressive encephalopathy after computer tomography (CT) arthrography of the ankle. CASE REPORT: We describe a 64-year-old male who underwent CT-arthrography of the left ankle, after the intra-articular injection of 20 ml of air he experienced progressive neurologic and hemodynamic deterioration. A brain CT showed a small amount of air in a right frontal sulcus. Hyperbaric oxygen therapy (HBO) was initiated after a delay of 16 hours and resulted in a complete recovery. A transesophageal echocardiography confirmed the presence of a right-left shunt. CONCLUSIONS: This case of paradoxical air embolism with severe neurological manifestations after arthrography of the ankle, emphasizes that air embolism should be considered in all patients with neurologic and/or hemodynamic deterioration after the injection of intra articular air. Furthermore a delay of more then 6 hours is no reason to withhold HBO in these patients. |
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Authors:
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Marcella C A Müller; Sjoerd M Lagarde; Menno R Germans; Nicole P Juffermans |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Medical science monitor : international medical journal of experimental and clinical research Volume: 16 ISSN: 1643-3750 ISO Abbreviation: Med. Sci. Monit. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-28 Completed Date: 2010-09-21 Revised Date: 2011-06-14 |
Medline Journal Info:
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Nlm Unique ID: 9609063 Medline TA: Med Sci Monit Country: Poland |
Other Details:
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Languages: eng Pagination: CS92-4 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands. m.c.muller@amc.uva.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ankle Joint
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radiography* Arthrography / adverse effects* Embolism, Air / etiology*, radiography Humans Intracranial Embolism / etiology*, radiography Male Middle Aged Tomography, X-Ray Computed / adverse effects |
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