J Neurocrit Care.  2019 Jun;12(1):51-54. 10.18700/jnc.190075.

Status epilepticus due to cerebral air embolism after the Valsalva maneuver

• Lyou HJ
• Lee HJ
• Lee GY
• Kim WJ

• KMID: 2452827
• DOI: http://doi.org/10.18700/jnc.190075

Abstract

BACKGROUND
Cerebral air embolism is uncommon but potentially causes catastrophic events such as cardiac damage or even death. However, due to a low overall incidence, it may go undiagnosed.
CASE REPORT
A 56-year-old man with a medical history of right upper lobectomy due to lung cancer showed changes in mental status after the Valsalva maneuver, followed by status epilepticus during admission. Brain and chest computed tomography showed cerebral air embolism and accidental pneumothorax in the right major fissure. After antiepileptic drug infusion and oxygen therapy, he recovered completely.
CONCLUSION
Since cerebral air embolism may result in fatal outcomes, it should be suspected in patients with sudden neurological deterioration after routine medical procedures.

Keyword

Status epilepticus; Embolism, air; Pneumothorax; Valsalva maneuver

MeSH Terms

Brain
Embolism, Air*
Fatal Outcome
Humans
Incidence
Lung Neoplasms
Middle Aged
Oxygen
Pneumothorax
Status Epilepticus*
Thorax
Valsalva Maneuver*
Oxygen

Figure

• 

  Fig. 1. (A) Brain computed tomography 30 minutes after symptom onset; multiple air bubbles observed prominently in the right parenchymal and subarachnoid vessels (arrowheads) . (B, C) Brain magnetic resonance imaging after 5 days after symptom onset; diffuse leptomeningeal enhancement of the right frontal, bilateral parietooccipital, and bilateral cerebellum with diffuse enhancement in the perivascular space of deep white matter(arrows).

• 

  Fig. 2. (A, B) Chest computed tomography; localized pneumothorax in the right major fissure.

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