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Cerebral air embolism associated with penetrating lung injury: a case report and review of the literature

机译：脑空气栓塞与穿透性肺损伤相关：一例病例报告并文献复习

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Case A 44‐year‐old man intentionally stabbed himself in the anterior neck and left thorax with a fruit knife. Physical examination revealed two open wounds entering the thoracic cavity in the front chest, and a stab wound entering the trachea at the neck. Two chest tubes were initially inserted for the left lung injury with open hemopneumothorax. Nevertheless, the worsening oxygenation required positive pressure ventilation ( PPV ) with endotracheal intubation. Outcome Right hemiparesis was found during weaning from PPV . Magnetic resonance imaging revealed multiple infarctions in the area of the bifrontal and right temporal lobes. Cerebral air embolism ( CAE ) was strongly suspected from the imaging findings and clinical course. Conclusion We concluded that mechanical ventilation was strongly involved in the occurrence of CAE . If delayed abnormal neurological findings are observed in patients with penetrating lung injuries receiving PPV management, CAE should be considered. In this case, a man who stabbed himself in the left thorax recieved positive pressure ventilation. Right hemiparesis appeared upon weaning from mechanical ventilation. DWI findings demonstrated characteristic laminar cortical hyperintense lesions in multiple lobes. Cerebral air embolism was strongly suspected from the imaging findings and clinical course.
机译：案例一名44岁的男子故意用水果刀刺伤了前颈部，并将其刺入胸腔。体格检查发现有两个开放的伤口进入前胸部的胸腔，有一个刺伤进入颈部的气管。最初插入两根胸管，以治疗开放性血气胸对左肺造成伤害。然而，恶化的氧合作用需要气管插管的正压通气（PPV）。从PPV断奶时发现结果右偏瘫。磁共振成像显示在双额叶和右颞叶区域有多个梗塞。从影像学表现和临床过程中强烈怀疑脑气栓塞（CAE）。结论我们得出结论，机械通气与CAE的发生密切相关。如果在接受PPV处理的肺部穿透性损伤患者中观察到延迟的异常神经学发现，则应考虑CAE。在这种情况下，一个刺入左胸的男子获得了正压通气。机械通气断奶时出现右偏瘫。 DWI的发现显示出多叶特征性层状皮质高强度病变。从影像学发现和临床过程中强烈怀疑脑气栓塞。

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