Acute Middle Cerebral Artery Infarction by Cerebral Air Embolism during Coronary Angiography
Hak-Ju Oh, MD1, Seok-Beom Kwon, MD, PhD1, Min-Ji Kim, MD1, Seong-Sook Hong, MD, PhD2, Yang-Ki Minn, MD, PhD1, San Jung, MD1, and Sung-Hee Hwang, MD, PhD1
1Department of Neurology, Hallym University College of Medicine, Seoul, Korea, 2Department of Radiology, Soonchunhyang University College of Medicine, Seoul, Korea
ABSTRACT
Background: Air embolism is caused by the entry of air into arteries of the systemic circulation. Cerebral air embolism may occur as a severe complication of invasive medical procedures such as cardiac catheterization or cardiopulmonary bypass during cardiac surgery. The average rate of air embolism during coronary angiography is reported 0.27%. Despite of this incidence rate, cerebral infarction by air embolism can be lethal. Case Report: We report a 75-year-old man who initially diagnosed as non ST elevation myocardial infarction. During coronary angiography, the patient showed left hemiparesis and semi-comatose mentality. Brain MRI demonstrated serpiginous intermingled low signal intensity indicating air embolism along the right cerebral hemisphere. Conclusions: This is the first report of a patient with middle cerebral artery infarction following huge air embolism occurred during coronary angiography. We should concern about air embolism during medical procedure.