Cerebral arterial gas embolism by helium: An unusual case successfully treated with hyperbaric oxygen and lidocaine

A 27-year-old man inhaled helium from an unregulated pressurized cylinder a nd underwent cerebral arterial gas embolism (CAGE), leaving him blind and w ith radiologic evidence initially suggesting cortical infarction. There was complete recovery of vision and substantial regression of the radiologic c hanges after 4 hyperbaric oxygen treatments and a 54-hour lidocaine infusio n, which began 6 hours after the accident. This is the second reported case of CAGE occurring by this mechanism and the first case of unequivocal CAGE in which lidocaine has been used as an adjunctive treatment with hyperbari c oxygen.