Cerebral Air Embolism Resulting from Invasive Medical Procedures Treatment with Hyperbaric Oxygen

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Abstract
The introduction of the air into the venous or arterial circulation can cause cerebral air embolism, leading to severe neurological deficit or death. Air injected into the arterial circulation may have direct access to the cerebral circulation. A patent foramen ovale provides a right-to-left shunt for venous air to embolize to the cerebral arteries. The ability of the pulmonary vasculature to filter air may be exceeded by bolus injections of large amounts of air. Patients (16) underwent hyperbaric O2 therapy for cerebral air embolism. Neurological symptoms included focal motor deficit, changes in sensorium, and visual and sensory deficits. Eight patients (50%) had complete relief of symptoms as a result of hyperbaric treatment, 5 (31%) had partial relief, and 3 patients (19%) had no benefit, 2 of whom died. The treatment of cerebral air embolism with hyperbaric O2 is based on mechanical compression of air bubbles to a much smaller size and the delivery of high doses of O2 to ischemic brain tissue.