Massive cerebral air embolism after blunt chest trauma with full neurological recovery

• Published in: Canadian journal of emergency medicine Vol. 18; no. 1; p. 62
• Main Authors: Reith, Georg, Bouillon, Bertil, Sakka, Samir G, Defosse, Jerome M, Gossmann, Axel, Probst, Christian
• Format: Journal Article
• Language: English
• Published: England 01-01-2016
• Subjects: Adult; Cognition - physiology; Electroencephalography; Embolism, Air - diagnosis; Embolism, Air - etiology; Embolism, Air - physiopathology; Follow-Up Studies; Humans; Intracranial Embolism - diagnosis; Intracranial Embolism - etiology; Intracranial Embolism - physiopathology; Magnetic Resonance Imaging; Male; Recovery of Function - physiology; Thoracic Injuries - complications; Thoracic Injuries - diagnosis; Tomography, X-Ray Computed; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - diagnosis; blunt chest trauma; arterial air embolism; bronchial fistula; treatment options; neurological recovery
• ISSN: 1481-8035
• DOI: 10.1017/cem.2014.78

Cerebral air embolism (CAE) is a common, often lethal, complication in blunt and penetrating chest trauma. The factors affecting the outcome of CAE patients are poorly understood, and there is no generally accepted treatment algorithm. In this report, we present the case of a 28-year-old male motorcyclist with a massive CAE, including bilateral internal carotid artery air on computed tomographic examination following blunt chest trauma. With prehospital intubation, oxygen, transfusion, and open laparotomy but without any specific treatment regarding the CAE, a follow-up computed tomography (CT) scan approximately 6 hours later showed resolution of the cerebrovascular air. Recovery was unremarkable, and the patient was discharged neurologically intact after 22 days.