Reyhanoglu Gizem, Moscicka Dominika, Guirguis George, Mousa Mina S
Florida State University Internal Medicine Residency Program, Tallahassee Memorial Hospital, Tallahassee, Florida, USA.
Florida State University College of Medicine, Tallahassee, Florida, USA.
Case Rep Radiol. 2025 Jul 18;2025:5236025. doi: 10.1155/crra/5236025. eCollection 2025.
Cerebral air embolism is a rare and potentially fatal medical condition that requires prompt recognition and management. Iatrogenic causes such as laparoscopic procedures, hysteroscopy, or central venous catheter (CVC) manipulation are well-documented etiologies. This article presents a case of an 80-year-old female who developed iatrogenic air emboli from CVC manipulation leading to left middle cerebral artery (MCA) syndrome due to suspected right-to-left shunt from pulmonary arteriovenous malformation (pulmonary AVM) or patent foramen ovale (PFO). Preexisting neurological deficits, elevated lactate levels, and sepsis with evidence of systemic hypoperfusion on admission hindered the early detection and treatment of air emboli. This case highlights the need for heightened awareness of CVC-related iatrogenic air embolism, particularly in patients with predisposing conditions such as pulmonary AVM and PFO. Comprehensive treatment strategies, including hyperbaric oxygen therapy, remain critical for achieving better outcomes.
脑空气栓塞是一种罕见且可能致命的医学状况，需要迅速识别和处理。诸如腹腔镜手术、宫腔镜检查或中心静脉导管（CVC）操作等医源性原因是有充分文献记载的病因。本文介绍了一例80岁女性病例，该患者因中心静脉导管操作引发医源性空气栓塞，由于怀疑存在因肺动静脉畸形（肺AVM）或卵圆孔未闭（PFO）导致的右向左分流，进而引发左大脑中动脉（MCA）综合征。入院时存在的神经功能缺损、乳酸水平升高以及伴有全身灌注不足证据的脓毒症阻碍了空气栓塞的早期检测和治疗。该病例凸显了提高对CVC相关医源性空气栓塞认识的必要性，尤其是对于患有诸如肺AVM和PFO等易感疾病的患者。包括高压氧治疗在内的综合治疗策略对于取得更好的治疗效果仍然至关重要。
