Serebral hava embolisi (SHE) diyaliz kateteri kullanımının nadir görülen bir komplikasyonudur. SHE sıklıkla santral venöz kateter (SVK) yerleştirilmesinden sonra ortaya çıksa da, nadiren SVK çıkarılması sonucunda da oluştuğu bildirilmiştir. 67 yaşında bir erkek hasta, oturur pozisyondayken sağ juguler vene yerleştirilen SVK’nın çıkarılmasından hemen sonra bilinç değişikliği, konuşamama ve sağ tarafında güçsüzlük yaşaması üzerine hızla acil servise getirildi. Muayenesinde konfüzyon ve spontan göz açma vardı, kooperasyon yoktu, sol üst ve alt ekstremiteler plejikti, sol plantar refleks (PR) ekstansör yanıtı vardı. Beyin bilgisayarlı tomografisinde (BT) sağ serebral hemisferde, oksipital bölgede ve sağ temporal bölgede hava görüntüleri saptandı. Toraks BT’de sağ juguler vende lümen içinde hava yoğunluğu saptandı. Difüzyon manyetik rezonans görüntülemede sağ parietal lob posteriorunda, özellikle subkortikal alanda, belirgin subakut iskemi ile uyumlu difüzyon kısıtlaması saptandı. Hastaya KAE tanısı konuldu ve tedavisi için hiperbarik oksijen başlandı. Hasta takiplerinde kötüleşmesi üzerine entübe edilerek yoğun bakım ünitesine alındı.
Bartolini, L. & Burger, K. (2015). Pearls & oy-sters: Cerebral venous air embolism after central catheter removal: Too much air can kill. Neurology, 84(13), e94-e96.
Chuang, D. Y., & Sundararajan V. A., (2019). Accidental air embolism: An uncommon cause of iatrogenic stroke. Stroke, 50(7), e183-e186.
Khan, H., & Zaidi, A. (2013). Paradoxical air embolism following central venous catheter removal.Case Reports, 2013, bcr2013200630.
Oyama, N., & Kitagawa, K. (2012). Air tract in the thrombus: Paradoxical cerebral air embolism through a residual catheter track. Journal of Stroke and Cerebrovascular Diseases, 21(8), 905-e11.
Pandurangadu, A. V., & Barawi, M (2012). A case report of cerebral air embolism after esophagogastroduodenoscopy:
Diagnosis and management in the emergency department. The Journal of emergency medicine, 43(6), 976-979.
Sahutoglu, T., &, Hasbal, N. B. (2017). Air embolism following removal of hemodialysis catheter. Hemodialysis International, 21(1), 29-34.
Schlimp, C. J., & Brodbeck, A. E. (2014). Cerebral venous air embolism: What is it and do we know howto deal with it properly?. JAMA neurology, 71(2), 243-243.
A Rare Complication of Central Venous Catheter Removal: Cerebral Air Embolism
Year 2024,
Volume: 9 Issue: 1, 27 - 31, 31.05.2024
Cerebral air embolism (CAE) is a rare complication of dialysis catheter use. Although CAE often occurs after central venous catheter (CVC) insertion, it has also been reported to rarely occur as a result of CVC removal. A 67-year-old male patient was quickly brought to the emergency room after he experienced altered consciousness, inability to speak, and weakness on the right side immediately after removal of the CVC inserted into the right jugular vein while the patient was in a sitting position. In his examination, he had confusion and spontaneous eye opening; there was no cooperation; left upper and lower extremities were plegic; and he had left plantar reflex (PR) extensor response. In the brain computed tomography (CT), air images were found in the right cerebral hemisphere, occipital region, and right temporal region. Thorax CT revealed air density within the lumen in the right jugular vein. Diffusion magnetic resonance imaging revealed diffusion restriction in the right parietal lobe posterior, especially in the subcortical area, consistent with pronounced subacute ischemia. The patient was diagnosed with CAE, and hyperbaric oxygen was started for his treatment. The patient was intubated upon worsening in the follow-ups and taken to the intensive care unit.
Bartolini, L. & Burger, K. (2015). Pearls & oy-sters: Cerebral venous air embolism after central catheter removal: Too much air can kill. Neurology, 84(13), e94-e96.
Chuang, D. Y., & Sundararajan V. A., (2019). Accidental air embolism: An uncommon cause of iatrogenic stroke. Stroke, 50(7), e183-e186.
Khan, H., & Zaidi, A. (2013). Paradoxical air embolism following central venous catheter removal.Case Reports, 2013, bcr2013200630.
Oyama, N., & Kitagawa, K. (2012). Air tract in the thrombus: Paradoxical cerebral air embolism through a residual catheter track. Journal of Stroke and Cerebrovascular Diseases, 21(8), 905-e11.
Pandurangadu, A. V., & Barawi, M (2012). A case report of cerebral air embolism after esophagogastroduodenoscopy:
Diagnosis and management in the emergency department. The Journal of emergency medicine, 43(6), 976-979.
Sahutoglu, T., &, Hasbal, N. B. (2017). Air embolism following removal of hemodialysis catheter. Hemodialysis International, 21(1), 29-34.
Schlimp, C. J., & Brodbeck, A. E. (2014). Cerebral venous air embolism: What is it and do we know howto deal with it properly?. JAMA neurology, 71(2), 243-243.
Mutlu, H., Sert, E. T., Kokulu, K., Yazıcı, R. (2024). A Rare Complication of Central Venous Catheter Removal: Cerebral Air Embolism. Turkish Medical Journal, 9(1), 27-31.