Cerebral venous air embolism during epidural injection in adult

Pulmonary Air embolism Associated with Pneumocephalus: A Case Report

Iatrogenic air embolism is associated with significant morbidity and mortality. Retrograde cerebral venous air embolism is most frequently associated with manipulation of venous access most commonly from central venous catheters. The ascension of air to the cerebral circulation is possibly due to the low specific gravity of air compared to blood and the performance of procedures in the sitting position. Increased right ventricular pressures in the setting of pulmonary thromboembolism may also contribute to the retrograde flow of air. We present the case of a 61-year-old woman who developed a massive pulmonary embolism and pneumocephalus, which was evident during contrast enhanced CT pulmonary angiography. Neurological deficits were not apparent and air resorption occurred after 48 hours of high flow oxygen therapy.

Cerebral Venous Air Embolism due to a Hidden Skull Fracture Secondary to Head Trauma

Cerebral venous air embolism is sometimes caused by head trauma. One of the paths of air entry is considered a skull fracture. We report a case of cerebral venous air embolism following head trauma. The patient was a 55-year-old man who fell and hit his head. A head computed tomography (CT) scan showed the air in the superior sagittal sinus; however, no skull fractures were detected. Follow-up CT revealed a fracture line in the right temporal bone. Cerebral venous air embolism following head trauma might have occult skull fractures even if CT could not show the skull fractures.