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Intra-arterial Air Thrombogenesis after Cerebral Air Embolism Complicating Lower Extremity Sclerotherapy

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Abstract

Background

Cerebral arterial gas embolism is a potentially life-threatening event. Intraarterial air can occlude blood flow directly or cause thrombosis. Sclerotherapy is an extremely rare cause of cerebral arterial gas embolism.

Method

Case-report.

Results

A 38-year-old female suffered acute onset of a left middle cerebral artery (LMCA) syndrome with an NIH stroke score of 11 approximately ten minutes after lower extremity sclerotherapy. CT angiogram demonstrated LMCA intraarterial air. Patient fully recovered after hyperbaric oxygen treatment with complete resolution of intraarterial air. However, thrombus replaced intraarterial air despite anticoagulation with heparin.

Conclusion

We provide radiological evidence of hyperbaric oxygen therapy resolving intraarterial air but also demonstrate the thrombogenic potential of this procedural complication.

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Authors and Affiliations

  1. Department of Neurology, Massachusetts General Hospital, WAC 7., 55 Fruit Street, Boston, MA, 02114, USA

    T. M. Leslie-Mazwi

  2. Department of Emergency Radiology, Massachusetts General Hospital, FND 02-210, 55 Fruit Street, Boston, MA, 02114, USA

    Laura L. Avery

  3. Departments of Neurology, Neurosurgery and Radiology, Massachusetts General Hospital, Building 149 Rm 6403, 13th St, Charlestown, MA, 02129, USA

    John R. Sims

Authors
  1. T. M. Leslie-Mazwi
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  2. Laura L. Avery
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  3. John R. Sims
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Corresponding author

Correspondence to John R. Sims.

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Leslie-Mazwi, T.M., Avery, L.L. & Sims, J.R. Intra-arterial Air Thrombogenesis after Cerebral Air Embolism Complicating Lower Extremity Sclerotherapy. Neurocrit Care 11, 97–100 (2009). https://doi.org/10.1007/s12028-009-9202-3

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  • DOI: https://doi.org/10.1007/s12028-009-9202-3

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