[Convulsive syndrome as a manifestation of acute cerebral damage due to
paradoxical air embolism in neurosurgical patients. Series of clinical cases and literature review].
ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2020;
84:51-64. [PMID:
32412194 DOI:
10.17116/neiro20208402151]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction
Paradoxical air embolism (PAE) is a rare potentially fatal complication followed by entering of air emboli from the right cardiac chambers and pulmonary artery to large circulation circle.
Objective
To analyze five patients who underwent neurosurgical intervention complicated by PAE and early postoperative convulsive syndrome.
Material and methods
There were five patients who developed early postoperative convulsive syndrome after previous neurosurgery in sitting position complicated by PAE. Convulsive syndrome required intensive care at the ICU. MRI confirmed ischemic foci de novo outside the zone of surgical intervention in all cases. All patients underwent video-EEG monitoring in order to select anticonvulsant therapy and evaluate its effectiveness. The authors were able to match the epileptogenic focus in the cerebral cortex with MRI data. Available literature data devoted to the problem of convulsive syndrome after neurosurgery complicated by PAE were analyzed.
Results
The focus of epileptiform activity coincided with one of the foci of hyperintense MR signal in all cases.
Conclusion
Video-EEG monitoring is advisable in patients with impaired consciousness who underwent neurosurgery complicated by PAE.
Collapse