title: Therapeutic hypothermia for severe cerebral air embolism complicating pleural lavage for empyema.
abstract: Cerebral air embolism during pleural lavage is a rare, but potentially fatal complication. We present a case of severe cerebral air embolism that developed during pleural lavage for empyema and was successfully treated by therapeutic hypothermia. A 77-year old male patient with empyema developed severe cerebral air embolism during pleural lavage via a chest tube. Cranial computed tomography and cranial magnetic resonance imaging showed many small bubbles and widespread infarction in the territory of the right middle cerebral artery. The patient received therapeutic hypothermia maintained at 33°C for 24 h and could leave the hospital without delayed sequelae.
authors.affiliation: Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Seiya
authors.initials: S
authors.lastname: Inoue
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takizawa
authors.forename: Yota
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Tangoku
mesh_terms: D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016724:Empyema, Pleural / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D007507:Therapeutic Irrigation / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome