Document Detail


Intracerebral hemorrhage related to systemic gas embolism during hysteroscopy.
MedLine Citation:
PMID:  20462140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Iatrogenic gas embolism is a rare but serious problem that has been documented in almost all medical specialties including gynecology. We present a 49-year-old woman undergoing operative hysteroscopy and myomectomy, who sustained sudden hypotension and decrease in the end-tidal carbon dioxid levels during the procedure. Systemic gas embolism was confirmed by echocardiographic evidence of bubbles in both right and left cardiac cavities and a rise of troponin. Hyperbaric oxygen was rapidly administered in addition to maintenance of vital functions and anti-thrombotic prevention with calciparin. A right hemiparesis was apparent after recovery from general anesthesia. Brain-computed tomography and magnetic resonnance imaging, performed on Days 3 and 2 respectively, showed a left fronto-parietal hematoma surrounded by edema. Having ruled out risk factors for a primary ischemic or hemorrhagic stroke, we concluded that hemorragic transformation of the ischemic cerebral lesion caused by gas embolism was responsible for the observed intraparenchymal hematoma. As far as we know, this is the first report relating cerebral gas embolism with an intracerebral hemorrhage. It provides an argument against anticoagulant therapy during the early stages of gas embolism care.
Authors:
Emilie Guillard; B?n?dicte Nancy; Herv? Floch; Anne Henckes; Guy Cochard; Josiane Arvieux; Charles Christian Arvieux
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc     Volume:  37     ISSN:  1066-2936     ISO Abbreviation:  Undersea Hyperb Med     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-05-13     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312954     Medline TA:  Undersea Hyperb Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-93     Citation Subset:  IM; S    
Affiliation:
CHU Brest, P?le Anesthesiology Intensive Care SAMU, Department of Anesthesiology and Intensive Care, Center for Hyperbaric Medicine, Brest, F-29200 France.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Cerebral Hemorrhage / diagnosis,  etiology*
Embolism, Air / complications*,  therapy
Female
Hematoma / diagnosis,  etiology*
Humans
Hyperbaric Oxygenation / methods
Hypotension / etiology
Hysteroscopy / adverse effects*
Intraoperative Complications / etiology
Middle Aged
Troponin / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin

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


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