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Case Reports
. 2016 May 3;3(4):411-414.
doi: 10.1002/ams2.211. eCollection 2016 Oct.

Controlled normothermia for a cerebral air embolism complicating computed tomography-guided transthoracic needle biopsy of the lung

Akitaka Yamamoto  1   2 , Kei Suzuki  1 , Yoshiaki Iwashita  1 , Kazuto Yokoyama  1 , Yukinari Omori  1 , Hidenori Suzuki  2 , Hiroshi Imai  1
Affiliations
Case Reports

Controlled normothermia for a cerebral air embolism complicating computed tomography-guided transthoracic needle biopsy of the lung

Akitaka Yamamoto et al. Acute Med Surg. .

Abstract

Case: A 74-year-old woman underwent computed tomography-guided transthoracic needle biopsy of a small lung mass. Immediately after the procedure, she lost consciousness. After resuscitation, her brain computed tomography scan confirmed a cerebral air embolism.

Outcome: As hyperbaric oxygenation was unavailable, she received controlled normothermia for neuroprotection. No cerebral symptoms were observed following treatment.

Conclusion: Air embolisms are rare, but fatal, complications of computed tomography-guided transthoracic needle biopsy. Therefore, clinicians should be familiar with early diagnosis and prompt treatment. Preventing hyperthermia might be effective for treating hypoxic brain injury caused by cerebral air embolisms.

Keywords: Air embolism; complication; hypoxic brain damage; ischemia; targeted temperature management.

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Figures

Figure 1
Figure 1
Computed tomography (CT) findings obtained at clinical onset of cerebral air embolism in a 74‐year‐old woman who underwent computed tomography‐guided transthoracic needle biopsy of a small lung mass. A, B, Chest CT showing small pulmonary hemorrhage (arrowhead) and air in the right and left atria (arrows). C, D, Brain CT showing air inflow in the right middle cerebral artery (arrows).
Figure 2
Figure 2
Magnetic resonance images of a 74‐year‐old woman who underwent computed tomography‐guided transthoracic needle biopsy of a small lung mass and developed cerebral air embolism. Images obtained 2 h after symptom onset. A, Diffusion‐weighted imaging showing no acute ischemic changes. B, T2‐weighted imaging showing no abnormality. C, Magnetic resonance angiography showing occlusion and segmental stenosis of the right middle cerebral artery.
Figure 3
Figure 3
Magnetic resonance images obtained 1 day after symptom onset 74‐year‐old woman who underwent computed tomography‐guided transthoracic needle biopsy of a small lung mass and developed cerebral air embolism. A, Diffusion‐weighted imaging showing cortical areas with restricted diffusion. B, T2‐weighted imaging revealing diffuse high‐signal intensity. C, Magnetic resonance angiography showing complete occlusion and stenosis resolution.
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