Abstract
Background
Esophagogastroduodenoscopy (EGD) is a rare cause of cerebral air embolism (CAE). To
our knowledge, there are only eight previously reported such cases in the history
of the procedure.
Objective
To identify clinical causes of CAE that can present to the emergency department (ED)
and to understand the appropriate management of CAE.
Case Report
A 71-year-old man presented with new-onset left-sided hemiparesis and dysarthria 2 h after undergoing an outpatient EGD. The patient was diagnosed with CAE in the ED
after undergoing a computed tomography scan of the brain without contrast.
Conclusion
The diagnosis of CAE is based on a thorough history and obtaining urgent radiographic
imaging of the brain. The definitive treatment of CAE involves hyperbaric oxygen.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Gas embolism.N Engl J Med. 2000; 342: 476-482
- Handbook on hyperbaric medicine.Springer, Berlin/New York1996
- Cerebral artery air embolism following an esophagogastroscopy: a case report.Neurology. 2001; 56: 136-137
- Stroke caused by cerebral air embolism during endoscopy.Gastrointest Endosc. 2003; 57: 134-135
- Cerebral air embolism during upper endoscopy: case report and review.Gastrointest Endosc. 2005; 61: 620-623
- Cerebral air embolism complicating esophagogastroduodenoscopy (EGD).Endoscopy. 2008; 40: E191-E192
- Cerebrovascular accident during endoscopy: consider cerebral air embolism, a rapidly reversible event with hyperbaric oxygen therapy.Gastrointest Endosc. 1998; 47: 70-73
- Bilateral cerebral air embolism.J Neurol. 2003; 250: 1115-1117
- Cerebral air embolism during endoscopy.Mo Med. 1997; 94: 704-707
- Cerebral air embolism after gastroduodenoscopy: complication of a duodenocaval fistula.Gastrointest Endosc. 1994; 40: 376-378
- Neurologic manifestations of cerebral air embolism as a complication of central venous catheterization.Crit Care Med. 2000; 28: 1621-1625
- Cerebral air embolism during contrast-enhanced CT.Pediatr Radiol. 2006; 36: 887
- Gas embolism: an exceptional complication of radial arterial catheterization.Acta Anaesthesiol Scand. 2004; 48: 1208-1210
- Massive cerebral arterial air embolism following arterial catheterization.Neuroradiology. 2005; 47: 892-894
- Massive cerebral air embolism after cardiopulmonary resuscitation.J Clin Neurosci. 2005; 12: 468-469
- Fatal scuba diving incident with massive gas embolism in cerebral and spinal arteries.Neuroradiology. 2005; 47: 411-416
- Neurologic injuries from scuba diving.Neurol Clin. 2008; 26 (xii): 297-308
- Delayed-onset cerebral arterial gas embolism in a commercial airline mechanic.Aviat Space Environ Med. 2003; 74: 977-980
- Cerebral air embolism after lung contusion. Case illustration.J Neurosurg. 2001; 95: 909
- Inactive tuberculosis cavity responsible for fatal cerebral air embolism.Intensive Care Med. 2006; 32: 622-623
- Cerebral and coronary gas embolism from the inhalation of pressurized helium.Crit Care Med. 2002; 30: 1156-1157
- Cerebral artery air embolism during endoscopic variceal ligation: case report.Gastrointest Endosc. 2004; 59: 123-125
- Cerebral arterial air embolism associated with esophageal carcinoma.Intern Med. 2002; 41: 903-904
- Transpulmonary passage of venous air emboli.J Appl Physiol. 1985; 59: 543-547
- Venous air embolism accompanied by echocardiographic evidence of transpulmonary air passage.Crit Care Med. 1996; 24: 359-361
- Postoperative management of cerebral air embolism: gas physiology for surgeons.Ann Thorac Surg. 1995; 60: 1138-1142
- Workshop panel. Final summary of recommendations: diving accident workshop 1990.in: Bennett P.B. Moon R.E. Diving accident management. Undersea and Hyperbaric Medical Society, Bethesda, MD1990: 366-369
- Treatment of decompression illness and latrogenic gas embolism.Respir Care Clin N Am. 1999; 5: 93-135
- Arterial gas embolism and hemoconcentration.J Emerg Med. 1994; 12: 147-153
- Hyperbaric-oxygen therapy.N Engl J Med. 1996; 334: 1642-1648
- Inhibition of human neutrophil beta2-integrin-dependent adherence by hyperbaric O2.Am J Physiol. 1997; 272: C770-C777
- Gesell L.B. Hyperbaric oxygen therapy indications. 12th edn. Undersea and Hyperbaric Medical Society, Durham, NC2008
- Pneumothorax as a complication of recompression therapy for cerebral arterial gas embolism.Undersea Biomed Res. 1992; 19: 447-455
Article info
Publication history
Published online: January 18, 2011
Accepted:
November 1,
2010
Received in revised form:
May 21,
2010
Received:
January 22,
2010
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.