Cerebral arterial gas embolism proven by computed tomography following transthoracic echocardiography using bubble contrast

• Published in: Diving and hyperbaric medicine Vol. 50; no. 3; pp. 300 - 302
• Main Authors: Banham, Neil Dg, Saw, Jacqui, Hankey, Graeme J, Ghia, Darshan
• Format: Journal Article
• Language: English
• Published: Australia The Journal of the South Pacific Underwater Medicine Society and the European Underwater and Baromedical Society 30-09-2020
• Subjects: Aged; Brain Ischemia; Case Report; Echocardiography; Echocardiography, Transesophageal; Embolism, Air - diagnostic imaging; Embolism, Air - etiology; Embolism, Air - therapy; Foramen Ovale, Patent; Humans; Male; Stroke - diagnostic imaging; Stroke - etiology; Stroke - therapy; Stroke; Hyperbaric oxygen treatment; Central nervous system; Case reports; Radiological imaging; Persistent (patent) foramen ovale (PFO); Doppler
• ISSN: 1833-3516; 2209-1491; 2209-1491
• DOI: 10.28920/dhm50.3.300-302

A 75 year-old male developed features of an acute stroke following bubble contrast echocardiography, which was shown on emergent computed tomography scanning to be a result of cerebral arterial gas embolism (CAGE) to the left middle cerebral artery. Ischaemic stroke symptoms have previously been reported as a rare complication of bubble contrast echocardiography. Radiologically proven CAGE from bubble contrast echocardiography had not been reported at the time this case occurred. Immediate provision of 100% oxygen and administration of hyperbaric oxygen are recommended treatments for CAGE and were associated with a substantial recovery for this patient.