• Diving Hyperb Med · Dec 2013

    Case Reports

    Cerebral air embolism after pleural streptokinase instillation.

    • Thorsten Janisch, Ullrich Siekmann, and Rüdger Kopp.
    • Euregio Centre for Hyperbaric Oxygenation, Aachen, Department of Surgical Intensive and Intermediate Care Medicine RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany, Fax: +49-(0)241-80-338-04-44, E-mail: tjanisch@ukaachen.de.
    • Diving Hyperb Med. 2013 Dec 1; 43 (4): 237-8.

    AbstractIatrogenic pulmonary barotrauma and cerebral arterial gas embolism (CAGE) may complicate a variety of medical procedures, such as certain types of surgery, drug administration through thoracic drainage, pneumoperitoneum, cystoscopy, bronchoscopy, etc. Hyperbaric oxygen treatment following the guidelines for CAGE in diving is the treatment of choice. Pleural streptokinase instillation is a common treatment for parapneumonic pleural effusion and may lead to CAGE. We present such a complication in a 79-year-old woman with a left-sided empyema. Neurological recovery was reasonable, but a left hemiparesis persisted. Prompt treatment of CAGE is necessary to avoid permanent injury and severe disability.

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