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Section Editor

Dr. A. Nagarajan

Department of Pulmonology, Kauvery Hospital, Cantonment, Trichy

History

A 65-years-old gentleman presented with complaints of loss of consciousness and vomiting for the past two days.

Associated illnesses

He was diagnosed to have systemic hypertension, diabetes mellitus, and chronic renal failure on haemodialysis.

Investigation

Non-contrast computed tomography of the brain was done.

What is your diagnosis?

Axial non-contrast CT brain showed multiple intra-axial air bubbles.

Notes

Cerebral air embolism (CAE) can be a potentially lethal complication.
The causes include CVC placement, endoscopy, hysteroscopy, laparoscopy, defibrillator placement.
Use of a haemodialysis catheter outside of haemodialysis and de-clotting of haemodialysis access has also been reported as causes of CAE.
With the advent of modern haemodialysis, there are safety measures in haemodialysis machines to protect against CAE, but it may still occur.

How do you treat? That is up to you to research!