Changes of cerebral air embolism shown by computed tomography

A case of cerebral air embolism, probably caused by air passed through a central venous catheter, is presented. The first computed tomography (CT) scans performed 1 h after the onset of symptoms, showed multiple air densities in the brain. Follow-up CT showed brain swelling and low densities consistent with infarction. Although CT is evidently useful in the diagnosis of cerebral air embolism (Hwang et al, 1983; Kearns et al,1984; Voorhies & Fraser, 1984; Jensen & Lipper, 1986),there are very few reports on the evolution of findings on CT. We stress that the appearance of cerebral air embolism on CT changes with time and that a normal initial CT scan cannot exclude air embolism. A 72-year-old man was admitted for treatment of gastric cancer. The patient underwent total gastrectomy in March 1985 and had a central venous line placed for parenteral nutrition. After surgery he suffered from a left-sided empyema and a drainage tube was inserted on March 28.