Teifurova Sabīne, Rācenis Kārlis, Freijs Ģirts, Skrastina Sigita, Balodis Arturs
Clinic of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
Department of Biology and Microbiology and Department of Internal Diseases, Riga Stradins University, Riga, Latvia.
Vasc Health Risk Manag. 2025 Aug 12;21:617-631. doi: 10.2147/VHRM.S537865. eCollection 2025.
Cerebral air embolism infarction (CAEI) is a rare but life-threatening condition that can affect the venous or arterial blood supply to the brain. Its aetiology is mostly iatrogenic, often resulting from complications of cardiothoracic or neurosurgical procedures, as well as manipulations with peripheral or central catheters. If undiagnosed and untreated, cerebral air embolism infarction can lead to long-term neurological consequences or even death. Diagnosis relies on clinical presentation and neuroimaging findings from CT and MRI, which are time-sensitive and not well described in the current literature.
We present a rare case of cerebral infarction as a complication of retrograde cerebral venous air embolism following haemodialysis catheter removal in a young patient, with management leading to a favourable outcome. The diagnosis was confirmed based on clinical manifestations and neuroimaging findings, with air emboli identified in the subarachnoid space on the CT scan, followed by characteristic MRI changes defined for cerebral air embolism infarcts. Timely diagnosis allowed for the rapid initiation of hyperbaric oxygen therapy and the rehabilitation process, resulting in positive outcomes.
Timely neuroimaging-particularly CT within the first 2 hours-is critical for diagnosing CAEI. MRI findings, including cytotoxic and vasogenic oedema in a distal vascular distribution and leptomeningeal enhancement, further support diagnosis. Early identification and treatment initiation are essential for improving patient outcomes.
脑空气栓塞性梗死（CAEI）是一种罕见但危及生命的疾病，可影响大脑的静脉或动脉血液供应。其病因大多为医源性，常由心胸或神经外科手术并发症以及外周或中心导管操作引起。如果未被诊断和治疗，脑空气栓塞性梗死可导致长期神经后果甚至死亡。诊断依赖于临床表现以及CT和MRI的神经影像学结果，这些结果具有时间敏感性，且当前文献中对此描述不多。
我们报告一例年轻患者在拔除血液透析导管后发生逆行性脑静脉空气栓塞并发脑梗死的罕见病例，经治疗取得了良好预后。根据临床表现和神经影像学结果确诊，CT扫描显示蛛网膜下腔有空气栓子，随后出现脑空气栓塞性梗死的特征性MRI变化。及时诊断使得能够迅速开始高压氧治疗和康复过程，从而取得了积极的结果。
及时进行神经影像学检查——尤其是在最初2小时内进行CT检查——对于诊断CAEI至关重要。MRI结果，包括远端血管分布区的细胞毒性和血管源性水肿以及软脑膜强化，进一步支持诊断。早期识别和开始治疗对于改善患者预后至关重要。
