脑空气栓塞(CAE)发生在各种临床情况下,如手术,血管造影,和血液透析;大多数是医源性的。在这里,我们报告了一名57岁的男子在进行气粉研磨处理后立即出现CAE的情况,这是常用的牙科。患者接受了植入周炎的气粉研磨治疗,治疗后立即,发生心脏骤停,并进行了心肺复苏。复苏后,在急诊室进行的脑部计算机断层扫描显示分散的暗密度,推测为空气。入院后的第二天,患者表现为右侧偏瘫,脑磁共振成像观察到多灶性脑梗死。因此,CAE被强烈怀疑。高压氧治疗(HBOT)后,事件发生4天后开始,患者恢复了意识,并表现出认知障碍的改善,在手动肌肉测试中,右下肢仅观察到4级肌肉无力。该案例强调了将CAE视为在涉及空气的临床手术期间发生的神经症状的可能原因的重要性。并增加了延迟HBOT治疗效果证据的积累。
Cerebral air embolism (CAE) occurs in various clinical situations such as surgery, angiography, and hemodialysis; most are iatrogenic. Here we report the
case of a 57-year-old man who developed CAE immediately after air-powder abrasive treatment, which is commonly used in dentistry. The patient underwent air-powder abrasive treatment for peri-implantitis, and immediately after the treatment, cardiac arrest occurred and cardio- pulmonary resuscitation was performed. After resuscitation, brain computed tomography performed in the emergency room showed scattered dark density presumed to be air. The day after admission, the patient showed right hemiplegia and a multifocal cerebral infarction was observed on brain magnetic resonance imaging. Therefore, CAE was strongly suspected. After hyperbaric oxygen treatment (HBOT), which started 4 days after the incident, the patient regained consciousness and showed improvement in cognitive impairment, and only grade 4 muscle weakness was observed in the right lower extremity on the manual muscle test. This
case highlights the importance of considering CAE as a possible cause of neurological symptoms occurring during clinical procedures involving air, and adds to the accumulation of evidence of therapeutic effects of delayed HBOT.