Xu Miaomiao, Zhou Jiejie, Cheng Xuemei, Han Yunfei, Hui Kangli
Department of Anesthesiology, Jinling Hospital, Nanjing, Jiangsu, China.
Department of Neurology, Jiangsu Province Hospital of Chinese Medicine , Nanjing, Jiangsu, China.
J Med Case Rep. 2025 Jul 1;19(1):299. doi: 10.1186/s13256-025-05305-z.
CO embolism has been documented in a range of laparoscopic procedures, and cerebral CO embolism is an extremely rare but lethal incidence of CO embolism, which may ultimately result in coma, stroke, disability, and mortality.
This paper presents an uncommon case of cerebral CO embolism that occurred during laparoscopic surgery, along with a thorough examination of existing literature. The patient (56-year-old Chinese female) experienced a loss of consciousness, generalized tonic-clonic seizures, and neurological impairments after undergoing a laparoscopic partial adrenalectomy. Multiple low-density lesions were detected by brain magnetic resonance imaging. The patient exhibited improvement and gradual recovery after undergoing therapies such as continuous hyperbaric oxygen therapy, hypothermic brain protection, hormone therapy, and anticoagulation.
We emphasize that cerebral CO embolism is a significant complication that must be given great importance in laparoscopic surgery. The comprehension of cerebral CO embolism, and effective communication between surgeons and anesthesiologists, play a crucial role in its diagnosis and avoiding inadequate treatment.
在一系列腹腔镜手术中均有一氧化碳（CO）栓塞的记录，而脑CO栓塞是CO栓塞极为罕见但致命的一种情况，最终可能导致昏迷、中风、残疾和死亡。
本文介绍了一例腹腔镜手术期间发生的罕见脑CO栓塞病例，并对现有文献进行了全面研究。该患者（一名56岁的中国女性）在接受腹腔镜部分肾上腺切除术后出现意识丧失、全身强直阵挛性发作和神经功能障碍。脑部磁共振成像检测到多个低密度病变。患者在接受持续高压氧治疗、亚低温脑保护、激素治疗和抗凝等治疗后病情改善并逐渐康复。
我们强调脑CO栓塞是一种重要的并发症，在腹腔镜手术中必须予以高度重视。对脑CO栓塞的认识以及外科医生和麻醉医生之间的有效沟通，对其诊断和避免治疗不足起着关键作用。
