Iatrogenic cerebral arterial air embolism during cerebral angiogram - A case report

Iatrogenic cerebral arterial air embolism (CAAE) is a complication related to various clinical procedures. Inadvertent injection of air into cerebral arteries during angiography has been reported to result in significant neurologic deficit. We present a patient who developed symptomatic CAAE in post-embolization angiography of direct type carotid cavernous fistula (CCF). Angiography documented the presence of air within the cerebral arteries. The patient developed drowsiness of consciousness and weakness of the contralateral extremities immediately after the CAAE occurred. Imaging studies including CT scan and MRI after the incident showed findings consistent with cerebral ischemia in the right cerebral hemisphere. The symptoms and signs of the patient improved gradually after CAAE and the patient was discharged on the 8th day after the event without neurologic sequelae.