title: Hyperintensity in the subarachnoid space on contrast-enhanced fluid-attenuated inversion-recovery magnetic resonance imaging after central venous catheter removal.
abstract: Cerebral air embolism is a rare complication of central venous catheterization. A 61-year-old man developed a left-sided hemiparesis immediately after his right jugular venous catheter removal. A diffusion-weighted magnetic resonance imaging (MRI) obtained 2 h after the symptom onset was normal. However, postgadolinium cerebral spinal fluid enhancement was seen on fluid-attenuated inversion-recovery MRI. A repeat diffusion-weighted MRI, 18 h later, showed restricted diffusion in the bilateral hemispheres. Disruption of the blood-brain barrier caused by the air bubbles might lead to accumulation of gadolinium in the subarachnoid space. Postgadolinium cerebral spinal fluid enhancement may be an early, sensitive predictor of blood-brain barrier disruption and impending cerebral infarct after air embolism.
authors.affiliation: Department of Neurology, Eulji General Hospital, Eulji University, 14 Hangeulbiseok-gil, Nowon-gu, Seoul, 139-711, Republic of Korea, cobnut1@gmail.com.
authors.forename: Kyusik
authors.initials: K
authors.lastname: Kang
authors.forename: Sehoon
authors.initials: S
authors.lastname: Lee
mesh_terms: D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002533:Cerebral Angiography; D003287:Contrast Media / Q000008:administration & dosage*; D005682:Gadolinium / Q000008:administration & dosage*; D006801:Humans; D020766:Intracranial Embolism / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D013346:Subarachnoid Space / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D005682:Gadolinium