PMC8510818_01
(a, b) Computerized tomography (CT) of the brain axial sections showing air embolism in the cortical branches of the posterior cerebral, middle, and anterior cerebral arteries, respectively (white arrows). (c) Same CT scan showing air in the superior sagittal sinus and cortical veins (black arrow). (d) CT scan showing air in the bilateral cavernous sinus (black arrow). (e, f) Diffusion-weighted sequence of a magnetic resonance image of the brain showing diffuse bilateral cortical anoxic injury. (g, h) TTE showing tricuspid valve vegetation (white arrow) and location of interatrial septum and PFO, respectively (white arrowhead). Bubbles in the left atrium and ventricle that crossed within 3 cardiac cycles.
CRINM2021-1063264.001.jpg
PMC8510818_01_CRINM2021-1063264.001.jpg
fig1
TV vegetation (Figure 1(g)). There was a large right-to-left shunt through the PFO on bubble study with spontaneous opacification of the left atrium and ventricle (Figure 1(h)). After stabilizing, a CT scan of the brain was obtained which showed diffuse arterial and venous cerebral air embolism (Figures 1(a)-1(d)). Magnetic resonance imaging (MRI) of the brain showed global anoxic injury and flattening of the globe at optic nerve insertion suggestive of intracranial hypertension (Figures 1(e)-1(f)).