[A 69-year-old man with temporary left-sided hemiparesis].
A 69-year-old man accidentally disconnected his central venous catheter (CVC) while standing at home. Within the same minute he developed left-sided hemiparesis which lasted for 30 minutes. A CT of the brain three hours later was normal. We believe cerebral air emboli from his disconnected CVC caused the transitory ischemic attack. This complication has previously been described several times and sometimes with air shown in the CT. The reason can be paradoxical embolism through an intracardial shunt or through physiological pulmonary arteriovenous shunts, or the air can pass retrogradely from the central vein to the cerebral venous system. When cerebral air emboli is suspected, the CVC must be secured, the patient should be placed in a recumbent position and given 100% O2, and hyperbaric oxygen therapy if symptoms persist. While placing and handling a CVC, the patient should be in a recumbent position, and the increased risk for air emboli in walking patients be taken into account.
Breivik
Kristin Lif
KL
Nevrologisk avdeling, Sentralsjukehuset i Sogn og Fjordane, 6807 Førde. kristinlif@hotmail.com
Nielsen
Erik Waage
EW
D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D003937:Diagnosis, Differential; D004618:Embolism, Air / Q000209:etiology*; D004868:Equipment Failure; D006429:Hemiplegia / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male