Chronological changes in cerebral air embolism that occurred during continuous drainage of infected lung bullae

We present a 43-year-old man with cerebral air embolism that occurred durin g continuous drainage of infected lung bullae, This complication is extreme ly rare, and may have been caused by the passage of air into the pulmonary venous circulation through a bronchovenous fistula and/or damaged pulmonary vessels. Air densities were demonstrated along the right frontal gyri on a CT performed 1 h after the onset of embolism, then moved to the deep corte x after 2.5 h. Three days later, a cortical infarct accompanied with extens ive white matter edema in the right frontal lobe was confirmed by MRI. Thes e CT and MRI findings may indicate the passage of intravascular air from th e superficial to the deep cortex and subsequent cerebral infarction, Copyri ght (C) 2000 S. Karger AG. Basel.