Case Report
Volume 12 Issue 8 - 2020
Non-Accidental Cerebral Air Embolism Secondary to Pulmonary Fibrosis
Lama Alshaikh-Mubarak* and Farah Aleisa
King Fahad Specialist Hospital Ammar Bin Thabit St, Al Muraikabat, Dammam, Saudi Arabia
*Corresponding Author:Lama Alshaikh-Mubarak, King Fahad Specialist Hospital Ammar Bin Thabit St, Al Muraikabat, Dammam, Saudi Arabia.
Received: June 09, 2020; Published: July 08, 2020


Cerebral air embolism (CAE) is a rare cause of stroke. Most cerebral air emboli are caused by iatrogenic factors, such as invasive cardiac and pulmonary procedures. Here, we report an unusual case of CAE not related to any medical intervention. We are reporting a case of 75-year-old man who has recent diagnosis of idiopathic pulmonary fibrosis, suddenly became unresponsive after straining in the toilet. A computed tomography (CT) scan of the brain done immediately in the hospital which revealed multiple dark foci (gas foci) bilaterally more in the right side. Patient was aphasic with bilateral weakness worse in upper limbs, MRI of the brain confirmed acute infarction in bilateral frontoparietal lobe, chest x ray done which showed no evidence of air in thorax. On Second day patient has echocardiogram which did not reveal significant cardiac shunt or PFO (patent foramen ovale). In this case, the increased intrathoracic pressure may have been a trigger for the CAE especially in a patient with pulmonary vulnerability. This case suggests that CAE can occur in a non-accidental situation.

Keywords: Cerebral Air Embolism; Straining, Pulmonary Fibrosis; Cerebral Infarction


  1. H Tabata., et al. “Cerebral Air Embolism with Pneumomediastinum Resulting from Emesis: A Case Report”. Journal of Stroke and Cerebrovascular Diseases 10 (2016): e178-e180.
  2. M Eimei., et al. “A Case Report of Cerebral Air Embolism Resulting from Spontaneous Pneumothorax and Pneumomediastinum”. Bulletin of Kyoto City Hospital 2 (2009): 40-43.
  3. , et al. “Cerebral air embolism as a complication of idiopathic pulmonary fibrosis. a case report”. European Stroke Journal (2018).
  4. TM Dudney and CG Elliott. “Pulmonary embolism from amniotic fluid, fat, and air”. Progress in Cardiovascular Diseases 6 (1994): 447-474.
  5. MB King and KR Harmon. “Unusual forms of pulmonary embolism”. Clinics in Chest Medicine 3 (1994): 561-580.
  6. HJ Schmitt and TM Hemmerling. “Venous air emboli occur during release of positive end-expiratory pressure and repositioning after sitting position surgery”. Anesthesia and Analgesia 2 (2002): 400-403.
  7. JG Heckmann., et al. “Neurologic manifestations of cerebral air embolism as a complication of central venous catheterization”. Critical Care Medicine 5 (2000): 1621-1625.
  8. CM Muth and ES Shank. “Gas embolism”. The New England Journal of Medicine 7 (2000): 476-482.
  9. PG Jorens., et al. “Nonthrombotic pulmonary embolism”. European Respiratory Journal 2 (2009): 452-474.
  10. T Gale and K Leslie. “Anaesthesia for neurosurgery in the sitting position”. Journal of Clinical Neuroscience 7 (2004): 693-696.
  11. AYC Wong and MG Irwin. “Large venous air embolism in the sitting position despite monitoring with transoesophageal echocardiography”. Anaesthesia8 (2005): 811-813.
  12. RM Leach., et al. “Hyperbaric oxygen therapy”. British Medical Journal 7166 (1998): 1140-1143.
  13. M Closon., et al. “Air embolism during an aircraft flight in a passenger with a pulmonary cyst: a favorable outcome with hyperbaric therapy”. Anesthesiology2 (2004): 539-542.
  14. P Blanc., et al. “Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation”. Intensive Care Medicine 5 (2002): 559-563.
  15. C Armon., et al. “Hyperbaric treatment of cerebral air embolism sustained during an open-heart surgical procedure”. Mayo Clinic Proceedings 6 (1991): 565-571.
  16. A Ziser., et al. “Hyperbaric oxygen therapy for massive arterial air embolism during cardiac operations”. The Journal of Thoracic and Cardiovascular Surgery 4 (1999): 818-821.
  17. AJ Gibson and FM Davis. “Hyperbaric oxygen therapy in the treatment of post cardiac surgical strokes--a case series and review of the literature”. Anaesthesia and Intensive Care 1 (2010): 175-184.
Citation: Lama Alshaikh-Mubarak and Farah Aleisa. “Non-Accidental Cerebral Air Embolism Secondary to Pulmonary Fibrosis”. EC Neurology 12.8 (2020): 07-11.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the December issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 20, 2021.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to