Cerebral arterial gas embolism by helium: an unusual case successfully treated with hyperbaric oxygen and lidocaine.
A 27-year-old man inhaled helium from an unregulated pressurized cylinder and underwent cerebral arterial gas embolism (CAGE), leaving him blind and with radiologic evidence initially suggesting cortical infarction. There was complete recovery of vision and substantial regression of the radiologic changes after 4 hyperbaric oxygen treatments and a 54-hour lidocaine infusion, which began 6 hours after the accident. This is the second reported case of CAGE occurring by this mechanism and the first case of unequivocal CAGE in which lidocaine has been used as an adjunctive treatment with hyperbaric oxygen.
Mitchell
S J
SJ
Wesley Centre for Hyperbaric Medicine, Brisbane, Australia. smitchell@wesley.com.au
Benson
M
M
Vadlamudi
L
L
Miller
P
P
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001766:Blindness / Q000209:etiology; D002536:Cerebral Arteries; D004618:Embolism, Air / Q000209:etiology* / Q000628:therapy*; D006371:Helium / Q000009:adverse effects*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male
D000889:Anti-Arrhythmia Agents; D006371:Helium; D008012:Lidocaine