title: Delayed recovery following laparoscopic partial hepatectomy.
abstract: We present a 42-year-old woman with unexpected coma after laparoscopic partial hepatectomy. MRI demonstrated ischaemic cerebral lesions. Further investigation revealed a patent foramen ovale. Cryptogenic stroke arising from a paradoxical carbon dioxide embolism was diagnosed. After 5 days of intensive care, she made a near complete recovery. Perioperative stroke, paradoxical emboli during surgery, patent foramen ovale, carbon dioxide cerebral embolism and therapeutic strategies are discussed.
authors.affiliation: Department of Critical Care, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels, Belgium. viola.vangorp@hotmail.com
authors.forename: Viola
authors.initials: V
authors.lastname: Van Gorp
authors.forename: Marc
authors.initials: M
authors.lastname: Diltoer
authors.forename: Georges
authors.initials: G
authors.lastname: Delvaux
authors.forename: Christian
authors.initials: C
authors.lastname: Verborgh
mesh_terms: D000328:Adult; D002245:Carbon Dioxide / Q000009:adverse effects; D003128:Coma / Q000209:etiology; D003422:Critical Care; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000175:diagnosis; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008279:Magnetic Resonance Imaging; D020521:Stroke / Q000175:diagnosis / Q000209:etiology
chemical_list: D002245:Carbon Dioxide