Cerebral arterial air embolism associated with pneumothorax in a patient with pressure support ventilation

A 20-year-old woman was admitted to the ICU following a road traffic accide nt. She had a periorbital haematoma with a normal cerebral state on CT-scan , intrahepatic and intratrasplenic haematomas and several fractures of the limb that were fixed on day 3. Twenty-four hours later, she developed a cou gh with symptoms of decerebration The head CT-scan showed diffuse pneumocep halus suitable with cerebral air embolism and the chest X ray a right tensi on pneumothorax. A chest tube was inserted. Despite the lack of hyperbaric oxygen therapy the patient recovered fully. The pneumocephalus disappeared totally after 48 hours. Seven days later, CT-scan of the head with coronal slides showed an orbital floor fracture associated with an intra-orbital ae rocele. (C) 2000 Editions scientifiques et medicales Elsevier SAS.