Retrograde Cerebral Venous Air Embolism: A Case Report and Review of Literature

We present a patient with cerebral venous air embolism after central venous catheterization (CVC) removal. Clinicians and radiologists should be aware of this possibility. This 63-year-old man with right lower lung cancer was admitted to the hospital for surgery. After surgery, CVC was removed then the patient was found unconscious. Immediate brain computed tomography (CT) showed air collection in bilateral cavernous sinuses, straight sinus and bilateral cerebral cortical veins, suggesting cerebral venous air embolism. Magnetic resonance imaging (MRI) obtained 10 hours after CT showed no residual air in the venous sinus system and no apparent abnormality. Follow-up MRI of brain 12 days later revealed bilateral cerebral subacute infarction with cortical pseudolaminar necrosis. He received supportive treatment with gradual return of consciousness despite remaining paralyzed.