Massive intracerebral air embolism associated with meningitis and lumbar spondylitis: case report

Spontaneous Cerebral Air Embolism-An Unusual Scenario

The introduction of air into cerebral venous or arterial circulation known as cerebral air embolism (CAE) is a rare clinical entity. CAE is commonly iatrogenic secondary to central venous catheter (CVC) placement or removal, various endoscopic procedures, or trauma or surgical scenarios. Here we report a case of spontaneous CAE in an unusual scenario. A 71-year-old male presented to emergency after developing giddiness following a yoga session. His MRI showed air embolism in the posterior fossa along cerebellar folia, prepontine, and suprasellar cisterns and tracking superiorly along the tentorium cerebelli. CAE is a rare clinical entity. Our case had CAE as a complication of cholesteatoma and possibly got triggered due to change in air pressor dynamics during yoga session.

Post-traumatic venous and systemic air embolism associated with spinal epidural emphysema: Multi-slice computed tomography diagnosis

A 30-year-old man was admitted with chest trauma after a road traffic accident. The patient was paraplegic and suffered from transient monoparesia of the left arm. The chest X-ray revealed a severe right tension pneumothorax and thoracic spine fractures. Emergency right thoracic drainage was carried out followed by angiography. Unfortunately the patient died and an autopsy was not permitted. Consequently post-mortem multi-slice computed tomography (MSCT) was performed, revealing presence of air inside the right cerebral arteries, bilateral pneumothorax accompanied by a severe right tension pneumothorax, bilateral haematic pleural effusion, pneumomediastinum and bilateral lung contusions. Air was also observed within the right coronary artery, ascending aorta and right ventricle. Thoracic and cervical spinal epidural emphysema were diagnosed. Venous air embolism followed by arterial air embolism producing paradoxical embolism was diagnosed. To the best of our knowledge, this is the first case illustrating by post-mortem MSCT such simultaneous complications after chest trauma as spinal epidural emphysema and cerebral and coronary air embolism.