Cerebral arterial air embolism associated with pneumothorax in a patient with pressure support ventilation

A 20-year-old woman was admitted to the ICU following a road traffic accident. She had a periorbital haematoma with a normal cerebral state on CT-scan, intrahepatic and intrasplenic haematomas and several fractures of the limb that were fixed on day 3. Twenty-four hours later, she developed a cough...

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Bibliographic Details
Published in:Annales françaises d'anesthésie et de réanimation 2000-04, Vol.19 (4), p.249
Main Authors: Cavadore, P, Brunat, G, Perrigault, P F, Colson, P
Format: Article
Language:fre
Subjects:
Accidents, Traffic
Adult
Cerebral Hemorrhage
Embolism, Air - complications
Embolism, Air - diagnostic imaging
Female
Fractures, Bone
Humans
Intracranial Embolism - complications
Intracranial Embolism - diagnostic imaging
Multiple Trauma
Pneumothorax - complications
Pneumothorax - diagnostic imaging
Pneumothorax - therapy
Positive-Pressure Respiration
Tomography, X-Ray Computed
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Summary:A 20-year-old woman was admitted to the ICU following a road traffic accident. She had a periorbital haematoma with a normal cerebral state on CT-scan, intrahepatic and intrasplenic haematomas and several fractures of the limb that were fixed on day 3. Twenty-four hours later, she developed a cough with symptoms of decerebration The head CT-scan showed diffuse pneumocephalus suitable with cerebral air embolism and the chest X ray a right tension pneumothorax. A chest tube was inserted. Despite the lack of hyperbaric oxygen therapy the patient recovered fully. The pneumocephalus disappeared totally after 48 hours. Seven days later, CT-scan of the head with coronal slides showed an orbital floor fracture associated with an intra-orbital aerocele.
ISSN:0750-7658