Cerebral gas embolism secondary to withdrawal of a central venous line

AIM: To report a case of cerebral gas embolism secondary to the withdrawal of a central venous line in a patient who had recently undergone abdominal surgery. CASE REPORT: An 82-year-old male who suddenly presented myoclonias in the right upper extremity and a sharp drop in the level of consciousness. A computerised tomography (CT) scan revealed air bubbles in the intracranial circulatory system and associated infarction in the right hemisphere. The patient's clinical progression was poor and he died some days later. CONCLUSIONS: Cerebral gas embolism can be diagnosed using a CT scan of the head if it is performed immediately after the entrance of air into the bloodstream inside the brain. In later phases, findings are unspecific and difficult to distinguish from ischaemic infarction or from diffuse leukoencephalopathy. Treatment is based on supportive measures and, in some cases, hyperbaric oxygen, although their true effectiveness is a controversial issue. Cerebral gas embolism is a potentially fatal and avoidable complication in patients with a central venous line or other iatrogenic procedures that can allow air to enter the arterial or venous circulatory systems.