Complete Resolution of Cerebral Air Embolism Secondary to a Transbronchial Needle Aspiration

S. Perinel Ragey, P. Garnier, J.-M. Vergnon
2013 Respiration  
primitive lung adenocarcinoma. Immediately after the puncture, an epileptic seizure occurred with right rotation of the head and a tonic seizure of the left arm followed by left hemiplegia. A brain CT scan performed almost immediately showed no abnormalities and a chest radiography did not show any pleural or mediastinal aeric image. A few hours later, clonic seizures occurred and brain MRI showed lesions compatible with air embolisms (right gyral cortical location). Several hyperbaric therapy
more » ... essions successfully cured the neurological deficit. Despite its rarity, each practitioner of TBNA has to be aware of this side effect and its early treatment. The mechanism of such accidents remains unclear, but probably involves high bronchial pressure and venous trauma. Abstract Air embolism following transbronchial needle aspiration (TBNA) is extremely rare. To date, only 1 case has been described (estimated incidence: 0.02-0.07%). Here, a 70-yearold patient developed a left upper-lobe alveolar syndrome with no response to well-conducted antibiotic treatments. Conventional bronchoscopy was normal, but virtual bronchoscopy showed that the tumor was contiguous to the left B3-B4 division. During a second bronchoscopy, a TBNA was performed without bleeding, and pathology later revealed • Air embolism following transbronchial needle aspiration (TBNA) is extremely rare but is often fatal. • The treatment of these events involves the use of oxygen and hyperbaric therapy, but evidence of efficacy is lacking.
doi:10.1159/000354790 pmid:24281247 fatcat:rgcsgnsrnnhw5axg7ku36uc2bq