A favorable outcome despite a 39-hour treatment delay for arterial gas embolism: case report.

Journal Article (Journal Article)

Cerebral arterial gas embolism (CAGE) occurs when gas enters the cerebral arterial vasculature. CAGE can occur during sitting craniotomies, cranial trauma or secondary to gas embolism from the heart. A far less common cause of CAGE is vascular entrainment of gas during endoscopic procedures. We present the case of a 49-year-old male who developed a CAGE following an esophagoduodenoscopy (EGD) biopsy. Due to a delay in diagnosis, the patient was not treated with hyperbaric oxygen (HBO₂) therapy until 39 hours after the inciting event. Despite presenting to our institution non-responsive and with decorticate posturing, the patient was eventually discharged to a rehabilitation facility, with only mild left upper extremity weakness. This delay in HBO₂ treatment represents the longest delay in treatment to our knowledge for a patient suffering from CAGE secondary to EGD. In addition to the clinical case report, we discuss the etiology of CAGE and the evidence supporting early HBO₂ treatment, as well as the data demonstrating efficacy even after considerable treatment delay.

Full Text

Duke Authors

Cited Authors

  • Covington, D; Bielawski, A; Sadler, C; Latham, E

Published Date

  • July 2016

Published In

Volume / Issue

  • 43 / 4

Start / End Page

  • 457 - 461

PubMed ID

  • 28763175

International Standard Serial Number (ISSN)

  • 1066-2936

Language

  • eng

Conference Location

  • United States