Kugiyama Tomoko, Koganemaru Masamichi, Kuhara Asako, Nabeta Masakazu, Uchiyama Yusuke, Tanaka Norimitsu, Kawabata Masahiro, Abe Toshi
Department of Radiology, Kurume University School of Medicine.
Department of Emergency and Critical Care Medicine, Kurume University School of Medicine.
Kurume Med J. 2018 Dec 21;65(1):17-21. doi: 10.2739/kurumemedj.MS651006. Epub 2018 Aug 30.
Cerebral air embolism following central venous catheter (CVC) removal is extremely rare. We report a case of cerebral air embolism with loss of consciousness after removal of CVC caused by pulmonary arteriovenous malformation (PAVM). Computed tomography revealed air bubbles in the internal carotid arteries along the sulci in the cerebral hemispheres, as well as a PAVM. The cerebral air embolism was treated with hyperbaric oxygen and intravenous thrombolytic therapy, and transcatheter embolization of the PAVM was performed. When inserting/removing CVC in a patient with a small PAVM, treatment of the PAVM, irrespective of its size, could prevent the type of complication that occurred in our present case.
中心静脉导管（CVC）拔除后发生脑空气栓塞极为罕见。我们报告一例因肺动静脉畸形（PAVM）导致CVC拔除后出现意识丧失的脑空气栓塞病例。计算机断层扫描显示大脑半球脑沟处颈内动脉有气泡，以及存在PAVM。该脑空气栓塞采用高压氧和静脉溶栓治疗，并对PAVM进行了经导管栓塞。在患有小型PAVM的患者中插入/拔除CVC时，无论PAVM大小，对其进行治疗都可预防我们本病例中出现的那种并发症。
