Neurocritical Care

, Volume 11, Issue 1, pp 97–100

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

  • T. M. Leslie-Mazwi
  • Laura L. Avery
  • John R. Sims
Practical Pearl

DOI: 10.1007/s12028-009-9202-3

Cite this article as:
Leslie-Mazwi, T.M., Avery, L.L. & Sims, J.R. Neurocrit Care (2009) 11: 97. doi:10.1007/s12028-009-9202-3



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.




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.


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


Hyperbaric oxygenCerebral infarctionThrombosisArterial gas embolismSclerotherapyComplication

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • T. M. Leslie-Mazwi
    • 1
  • Laura L. Avery
    • 2
  • John R. Sims
    • 3
  1. 1.Department of NeurologyMassachusetts General HospitalBostonUSA
  2. 2.Department of Emergency RadiologyMassachusetts General HospitalBostonUSA
  3. 3.Departments of Neurology, Neurosurgery and RadiologyMassachusetts General HospitalCharlestownUSA