Document Detail


Cerebral air embolism after arthrography of the ankle.
MedLine Citation:
PMID:  20581782     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Marcella C A Müller; Sjoerd M Lagarde; Menno R Germans; Nicole P Juffermans
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
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:
Created Date:  2010-06-28     Completed Date:  2010-09-21     Revised Date:  2011-06-14    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  CS92-4     Citation Subset:  IM    
Affiliation:
Department of Intensive Care, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands. m.c.muller@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Ankle Joint / radiography*
Arthrography / adverse effects*
Embolism, Air / etiology*,  radiography
Humans
Intracranial Embolism / etiology*,  radiography
Male
Middle Aged
Tomography, X-Ray Computed / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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