title: Cerebral air embolism after intrathoracic anti-cancer drug administration.
abstract: We report a case of cerebral arterial air embolism that was followed by a brain computed tomographic scan and magnetic resonance imaging during the first week after onset. A 73-year-old man was admitted for treatment of pleural dissemination that was a recurrence after right lower bilectomy for advanced lung cancer. Thirty minutes after an anti-drug administration through the chest drainage tube, he lost consciousness shortly after coughing. A bubble in the inferior sagittal sinus was observed on the day of the stroke, which then disappeared within 24 hours. It seems that the anti-cancer agent evoked inflammation at the visceral pleura and the subject inhaled massive air flow into the systemic circulation.
authors.affiliation: Department of Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan. yosy.811kob@k3.dion.ne.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Hidenori
authors.initials: H
authors.lastname: Mukaida
authors.forename: Naoki
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: Wataru
authors.initials: W
authors.lastname: Takiyama
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D001929:Brain Edema / Q000209:etiology; D002545:Brain Ischemia / Q000209:etiology; D001983:Bronchial Fistula / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D002544:Cerebral Infarction / Q000209:etiology; D015505:Chest Tubes; D002945:Cisplatin / Q000008:administration & dosage; D003128:Coma / Q000209:etiology; D003131:Combined Modality Therapy; D003371:Cough; D018450:Disease Progression; D004618:Embolism, Air / Q000209:etiology*; D017809:Fatal Outcome; D005402:Fistula / Q000209:etiology; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007267:Injections / Q000009:adverse effects; D020766:Intracranial Embolism / Q000209:etiology*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D010844:Picibanil / Q000008:administration & dosage; D010994:Pleura / Q000293:injuries*; D035422:Pleural Cavity; D016066:Pleural Effusion, Malignant / Q000188:drug therapy; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000209:etiology*; D011667:Pulmonary Veins
chemical_list: D010844:Picibanil; D002945:Cisplatin