Abstract：
Central venous catheters (CVCs) are increasingly used across specialties for invasive haemodynamic monitoring and for the delivery of fluids, medications, and nutritional support. Cerebral air embolism (CAE) is a rare but potentially fatal complication associated with the insertion, maintenance, and removal of CVCs. It can occur through different mechanisms, including the direct retrograde ascension of air into the cerebral veins and paradoxical embolism due to a right-to-left intracardiac or intrapulmonary shunt. The \"hand-knob\" area is the cortical region within the primary motor cortex that contains the representation of the hand. It is located in the superior precentral gyrus and is the site of less than 1% of all ischaemic strokes. We report here the case of a patient who experienced an ischaemic stroke of the right \"hand-knob\" area, due to paradoxical CAE through a previously undiagnosed patent foramen ovale (PFO), after the insertion of a catheter in the right internal jugular vein. We also provide an overview of the pathophysiology, diagnosis, and treatment of CAE. Suspecting CAE in the case of an acute neurological event occurring in close temporal relationship with central venous catheterization is paramount to allow the early recognition and treatment of this uncommon form of iatrogenic stroke.
摘要：
中心静脉导管（CVC）越来越多地用于侵入性血流动力学监测和液体输送的专业。药物,和营养支持。脑空气栓塞（CAE）是一种罕见但可能致命的并发症，维护,并去除CVC。它可以通过不同的机制发生，包括由右向左的心内或肺内分流导致的空气直接逆行进入脑静脉和矛盾的栓塞。“手旋钮”区域是初级运动皮层内的皮质区域，其中包含手的表示。它位于中央上前回，占所有缺血性中风的不到1％。我们在这里报告一个病人经历了右“手旋钮”区域的缺血性中风，由于先前未诊断的卵圆孔未闭（PFO）的矛盾CAE，在右颈内静脉插入导管后。我们还提供了病理生理学的概述，诊断,CAE的治疗。在与中央静脉导管插入术有密切时间关系的急性神经系统事件的情况下，怀疑CAE对于早期识别和治疗这种罕见的医源性中风至关重要。
