title: Simultaneous left ventricular and cerebral artery air embolism after computed tomographic-guided transthoracic needle biopsy of the lung.
abstract: Air embolism is rare and potentially fatal. Its early recognition and prompt treatment can help to prevent life-threatening sequelae. Herein, we report the case of a 75-year-old man who underwent a computed tomographic-guided lung biopsy of a left-lower-lobe pulmonary nodule. A few minutes after the procedure, he experienced numbness and weakness in his right hand; this lasted for approximately 10 minutes and resolved on its own. Similar symptoms developed in his left hand and subsided in 5 minutes. His speech then became garbled. An urgent computed tomographic scan of the head showed no acute abnormality. Review of the chest computed tomographic scans that were performed during the biopsy revealed 10 cc of air in the left ventricular cavity. The patient was placed on 100% forced inspiratory oxygen and was kept in the Trendelenburg position on his left side. After 4 hours, computed tomography revealed that the air had been absorbed into the circulation. The patient had no residual neurologic deficits. In addition to reporting this case, we discuss possible causes of air embolism and the management of the condition after percutaneous lung biopsy.
authors.affiliation: Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, USA. aniruddha_rajput@rediffmail.com
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Singh
authors.forename: Ajay
authors.initials: A
authors.lastname: Ramanakumar
authors.forename: Joseph
authors.initials: J
authors.lastname: Hannan
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects*; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D018475:Head-Down Tilt; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006352:Heart Ventricles; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D010102:Oxygen Inhalation Therapy; D056888:Patient Positioning; D003074:Solitary Pulmonary Nodule / Q000473:pathology*; D013064:Speech Disorders / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome