Diário da Espinha

Fatal Cerebral Arterial Air Embolism Following Uneventful One-level Lumbar Decompressive Surgery

Abstract

Michael Pfeiffer, Frederick Meyer Zu Schwabedissen, Rutherford Andreas and Rozeik Christoph

Several cases with fatal cardiac output failure following coronary and ventricular air embolism and few cases with cerebral venous gas and air emboli have been reported after lumbar surgery. This is, to the best of our knowledge, the first case presented with a fatal cerebral arterial air embolism in the course of lumbar spine surgery without any cardiac and pulmonary symptoms or necessity of CPR. Conceivable pathways of the air embolus towards left posterior cerebral artery were either from right into left atrium or, far less probable, nevertheless having been reported for large air masses, trans-pulmonary. No patent oval foramen, however, had been detected prior to surgery by transthoracic sonography. This paper should create awareness about that rare complication and its caveats further be discussed by experts.