Nedelmann Max, Pittermann Patrick, Gast Klaus Kurt, Mueller-Forell Wibke, Dieterich Marianne
Department of Neurology, Johannes Gutenberg University, Mainz, Germany.
J Neuroimaging. 2007 Jul;17(3):258-60. doi: 10.1111/j.1552-6569.2006.00073.x.
Cerebral venous air entrapment is a rare finding on cranial computed tomography (CT) scan. Peripheral air embolism is discussed as a potential cause. However, the mechanism of retrograde passage through internal jugular valves and veins is unclear.
The case of a patient is reported, who had air entrapment in the left cavernous sinus. Prior to CT scanning, a peripheral intravenous line had been placed. Ultrasound revealed excessive insufficiency of the left internal jugular valve. To further study the mechanism of embolism, an echo contrast agent was injected into the cubital vein. A Valsalva maneuver resulted in retrograde transition of microbubbles across the insufficient valve. Valvular function on the unaffected right side was intact.
This case report gives insight into the mechanism of cerebral venous air embolism. This is the firstcase describing jugular valve insufficiency as the missing link between peripheral air embolism and cerebral venous air entrapment.
脑静脉空气潴留是头颅计算机断层扫描（CT）中罕见的表现。外周空气栓塞被认为是一种潜在原因。然而，空气通过颈内静脉瓣膜和静脉逆行的机制尚不清楚。
报告一例患者，其左侧海绵窦出现空气潴留。在CT扫描前，已放置外周静脉导管。超声显示左颈内静脉瓣膜严重功能不全。为进一步研究栓塞机制，向肘静脉注射了超声造影剂。瓦尔萨尔瓦动作导致微泡通过功能不全的瓣膜逆行。未受影响的右侧瓣膜功能正常。
本病例报告深入探讨了脑静脉空气栓塞的机制。这是首例将颈静脉瓣膜功能不全描述为外周空气栓塞与脑静脉空气潴留之间缺失环节的病例。
