Ahmed Basheer, Musa Ahmed, Ravindrane Arumugam, Meer Muhammad M
Psychiatry, Palmer Community Hospital, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, South Tyneside, GBR.
Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, GBR.
Cureus. 2024 Nov 13;16(11):e73621. doi: 10.7759/cureus.73621. eCollection 2024 Nov.
Cerebral air embolism (CAE) is a rare but life-threatening condition often associated with trauma, such as chest and skull injuries, which allow air to enter the venous system, as well as medical procedures and surgical interventions. It can occur during the insertion of peripheral cannulas or central midline catheters, following lung biopsy procedures, or during vascular surgeries, particularly those involving the head and neck region. CAE can also develop during the removal of central venous cannulas, as air may enter the bloodstream in the process. When air enters the bloodstream, it can travel to the cerebral blood vessels, where it may be trapped, forming bubbles that obstruct the blood flow. This blockage reduces oxygen supply to brain tissue, which can quickly lead to cell damage or ischemia if not resolved. We present the case of a 62-year-old male with an infective exacerbation of chronic obstructive pulmonary disease who developed acute unilateral sensorimotor weakness several days following midline catheter insertion for a prolonged course of antibiotic administration. Prompt detection and intervention are essential in managing CAE to minimize risks and prevent permanent damage. The role of diagnostic radiology is essential in the rapid diagnosis and management of CAE. Imaging techniques such as computed tomography (CT) scans, carotid and cerebral angiograms, and magnetic resonance imaging (MRI) of the head are invaluable for assessing cerebral arteries and determining the extent of ischemic damage over time. They can also show signs of air trapped either in the venous or arterial system as the complexity of CAE is heightened by air emboli affecting various vascular regions, including the cerebral venous sinuses, requiring comprehensive imaging for accurate diagnosis and management. While CT of the brain is essential for immediate diagnosis, follow-up MRI scans provide detailed insights into the progression of ischemic changes that may result from CAE.
脑空气栓塞（CAE）是一种罕见但危及生命的疾病，通常与创伤有关，如胸部和颅骨损伤，这些损伤会使空气进入静脉系统，也与医疗程序和外科手术有关。它可发生在外周套管或中心中线导管插入过程中、肺活检术后或血管手术期间，特别是涉及头颈部区域的手术。CAE也可在中心静脉导管拔除过程中发生，因为在此过程中空气可能进入血流。当空气进入血流时，它可进入脑血管，在那里可能被困住，形成气泡阻碍血流。这种阻塞会减少对脑组织的氧气供应，如果不解决，可迅速导致细胞损伤或局部缺血。我们报告一例62岁男性，患有慢性阻塞性肺疾病感染加重，在插入中线导管进行长期抗生素治疗几天后出现急性单侧感觉运动无力。及时检测和干预对于管理CAE以最小化风险和防止永久性损伤至关重要。诊断放射学在CAE的快速诊断和管理中起着至关重要的作用。诸如计算机断层扫描（CT）、颈动脉和脑血管造影以及头部磁共振成像（MRI）等成像技术对于评估脑动脉和确定随时间推移的缺血损伤程度非常宝贵。它们还可以显示静脉或动脉系统中被困空气的迹象，因为CAE的复杂性因影响包括脑静脉窦在内的各种血管区域的空气栓子而增加，需要全面成像以进行准确诊断和管理。虽然脑部CT对于立即诊断至关重要，但后续的MRI扫描可提供关于CAE可能导致的缺血性变化进展的详细见解。
