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. 2024 Dec 12;12(12):e70093.
doi: 10.1002/rcr2.70093. eCollection 2024 Dec.

Unexpected pulmonary edema following sitting position craniotomy: A venous air embolism complication

Ahmed Daqour  1   2 , Abdalkareem Fraij  2 , Dina Khawaja  2 , Tassnim Hussain  2 , Tawfiq Mabhouh  2 , Mohammad Salahaldin  1 , Motaz Saifi  3   4 , Mohammad Abuawad  5
Affiliations

Unexpected pulmonary edema following sitting position craniotomy: A venous air embolism complication

Ahmed Daqour et al. Respirol Case Rep. .

Abstract

We report a case of a 42-year-old female who had non-cardiogenic pulmonary edema following a setting position craniotomy to remove a left cerebellar pontine angle mass. During the operation, the patient experienced a sudden drop in her end-tidal CO2 levels, which needed an immediate intervention. After ruling out other potential causes, we determined that air venous embolism was the cause of this unexpected and serious complication. However, the condition was self-limited and resolved with supportive treatment after approximately 1 week. This case highlights the importance of recognizing and managing the unexpected complications of venous air embolism, as well as how prompt intervention and supportive treatment are critical for improving patient outcomes.

Keywords: craniotomy; pulmonary edema; setting position; venous air embolism.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
(A) Preoperative normal AP chest x‐ray. (B) Postoperative AP chest x‐ray showing bilateral lung congestion. (C) Seven days post‐operative AP chest x‐rays showing normal appearance of the lungs. (D) Lateral view. AP, antero‐posterior.
FIGURE 2
FIGURE 2
Postoperative echocardiogram showing preserved LV systolic, but dilated RV with reduced contraction and moderate tricuspid regurgitation.
FIGURE 3
FIGURE 3
(A, B) Coronal chest CT (mediastinal window) showing the pulmonary arteries. (C, D) Axial view.
See this image and copyright information in PMC

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