Journal List > J Korean Soc Radiol > v.63(4) > 1086827

J Korean Soc Radiol. 2010 Oct;63(4):307-310. Korean.
Published online October 31, 2010.  https://doi.org/10.3348/jksr.2010.63.4.307
Copyright © 2010 The Korean Society of Radiology
A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report
Ji Young Oh, M.D., Dong Woo Park, Chang Kok Hahm, M.D., Choong Ki Park, M.D., Seung Ro Lee, M.D. and Youngjun Lee, M.D.
Department of Radiology, College of Medicine, Hanyang University, Korea.

Address reprint requests to: Dong Woo Park, M.D., Department of Radiology, College of Medicine, Hanyang University, Guri Hospital, 249-1, Gyomun-dong, Guri-si, Gyeonggi-do 471-701, Korea. Tel. 82-31-560-2543, Fax. 82-31-560-2551, Email: dwpark@hanyang.ac.kr
Received October 16, 2009; Accepted July 25, 2010.

Abstract

Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis.

Keywords: Embolism, Air; Intracranial Embolism; Tuberculosis, Pulmonary; Tomography Scanner, X-Ray Computed; Diffusion Magnetic Resonance Imaging

Figures


Fig. 1
A. Chest X-ray shows advanced pulmonary tuberculosis.
B. A left internal mammary angiography on the day of admission reveals extensive hypervascularity in the left lung with an arteriovenous fistula from the left internal mammary artery (white arrow) to the pulmonary vein (black arrow).
Click for larger image


Fig. 2
A. Non-contrast axial CT demonstrates curvilinear low attenuation lesions in the sulci of the right frontal lobe (black arrows), suggestive of air embolism, 10 minutes after onset of the stroke.
B. Diffusion-weighted MR image obtained 3 hour after onset of the stroke shows no abnormal high signal intensity at right frontal lobe.

C. 2 days after the stroke, the air bubbles have disappeared and the cerebral sulcus and cortex (white arrows) becomes effaced and swollen at the same area on the CT scan.

D. Diffusion-weighted MR image shows progression of the cortical high-intensity indicating acute infarction in the same area.

Click for larger image

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