Cerebral air embolism after intrathoracic anti-cancer drug administration

Ann Thorac Surg. 2006 Sep;82(3):1121-3. doi: 10.1016/j.athoracsur.2006.01.051.

Abstract

We report a case of cerebral arterial air embolism that was followed by a brain computed tomographic scan and magnetic resonance imaging during the first week after onset. A 73-year-old man was admitted for treatment of pleural dissemination that was a recurrence after right lower bilectomy for advanced lung cancer. Thirty minutes after an anti-drug administration through the chest drainage tube, he lost consciousness shortly after coughing. A bubble in the inferior sagittal sinus was observed on the day of the stroke, which then disappeared within 24 hours. It seems that the anti-cancer agent evoked inflammation at the visceral pleura and the subject inhaled massive air flow into the systemic circulation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Edema / etiology
  • Brain Ischemia / etiology
  • Bronchial Fistula / etiology
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / surgery
  • Cerebral Infarction / etiology
  • Chest Tubes
  • Cisplatin / administration & dosage
  • Coma / etiology
  • Combined Modality Therapy
  • Cough
  • Disease Progression
  • Embolism, Air / etiology*
  • Fatal Outcome
  • Fistula / etiology
  • Hemiplegia / etiology
  • Humans
  • Injections / adverse effects
  • Intracranial Embolism / etiology*
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / surgery
  • Lymph Node Excision
  • Male
  • Picibanil / administration & dosage
  • Pleura / injuries*
  • Pleural Cavity
  • Pleural Effusion, Malignant / drug therapy
  • Pneumonectomy
  • Postoperative Complications / etiology*
  • Pulmonary Veins

Substances

  • Picibanil
  • Cisplatin