[Cerebral gas embolism secondary to withdrawal of a central venous line].
OBJECTIVE
To report a case of cerebral gas embolism secondary to the withdrawal of a central venous line in a patient who had recently undergone abdominal surgery.


METHODS
An 82-year-old male who suddenly presented myoclonias in the right upper extremity and a sharp drop in the level of consciousness. A computerised tomography (CT) scan revealed air bubbles in the intracranial circulatory system and associated infarction in the right hemisphere. The patient's clinical progression was poor and he died some days later.


CONCLUSIONS
Cerebral gas embolism can be diagnosed using a CT scan of the head if it is performed immediately after the entrance of air into the bloodstream inside the brain. In later phases, findings are unspecific and difficult to distinguish from ischaemic infarction or from diffuse leukoencephalopathy. Treatment is based on supportive measures and, in some cases, hyperbaric oxygen, although their true effectiveness is a controversial issue. Cerebral gas embolism is a potentially fatal and avoidable complication in patients with a central venous line or other iatrogenic procedures that can allow air to enter the arterial or venous circulatory systems.
Laguillo-Sala
G
G
Hospital Universitari Josep Trueta, 17007 Girona, España. laguillosala@yahoo.es
Cañete-Abajo
N
N
Castaño-Duque
C H
CH
Guardia-Mas
E
E
de Juan-Delago
M
M
Ruscalleda-Nadal
J
J
D000369:Aged, 80 and over; D002405:Catheterization, Central Venous; D020878:Device Removal / Q000009:adverse effects*; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D017809:Fatal Outcome; D042882:Gallstones / Q000150:complications; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000601:surgery; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed