J Korean Soc Radiol.  2019 Mar;80(2):345-350. 10.3348/jksr.2019.80.2.345.

Cerebral Air Embolism after Central Venous Catheter Removal in a Patient with a Patent Foramen Ovale: A Case Report and Literature Review

• Hahn HJ
• Lee GJ
• Kim KH
• Lee KE
• Shim JC
• Hwang DH
• Kim HK

• KMID: 2442525
• DOI: http://doi.org/10.3348/jksr.2019.80.2.345

Abstract

Central venous catheterization is a routinely performed procedure in clinical practice. While cerebral air embolism after the removal of the central venous catheter is very rare, it is one of the most serious complications that can lead to fatal outcomes. In this report, we present a rare case of a cerebral air embolism after the removal of the central venous catheter in a patient with a patent foramen ovale.

MeSH Terms

Catheterization, Central Venous
Central Venous Catheters*
Embolism, Air*
Fatal Outcome
Foramen Ovale, Patent*
Humans
Intracranial Embolism

Figure

• 

  Fig. 1 Cerebral air embolism following central venous catheter removal in a 67-year old woman with patent foramen ovale. A. Non-enhanced axial CT image of the brain shows a small linear marked low attenuation lesion (arrow) in the sulcus of the left frontal lobe, suggestive of an air embolism. B–E. DWI (B, C) demonstrated scattered high signal intensities along both cerebral hemispheres and basal ganglia with marked confluent high signal intensities at both frontal lobes, which were detected as an area of low signal intensity on the ADC map (D), suggesting an acute infarction. GRE image (E) shows multifocal dark signal dots (arrows) in the infarcted area, suggesting the presence of air emboli. F. TEE shows a flap-like opening between the RA and the LA, suggesting a patent foramen ovale (arrow). ADC = apparent diffusion coefficient, DWI = diffusion-weighted imaging, GRE = gradient-echo, LA = left atrium, RA = right atrium, TEE = transesophageal echocardiography

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