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Case Reports in Emergency Medicine
Volume 2018, Article ID 9496818, 4 pages
https://doi.org/10.1155/2018/9496818
Case Report

Cortical Blindness and Altered Mental Status following Routine Hemodialysis, a Case of Iatrogenic Cerebral Air Embolism

Thomas Jefferson University Hospital, 1020 Sansom Street, Room 1651, Thompson Building, Philadelphia, PA 19107, USA

Correspondence should be addressed to Lawrence Lau; ude.nosreffej@ual.ecnerwal

Received 14 September 2017; Accepted 12 February 2018; Published 14 March 2018

Academic Editor: Aristomenis K. Exadaktylos

Copyright © 2018 Lawrence Lau and Kory London. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cerebral air embolism is a known complication from a myriad of iatrogenic causes. This case describes a 60-year-old female presenting from hemodialysis with altered mental status, bilateral homonymous hemianopia, and repetitive speech. A noncontrast head CT revealed air in the vein of Galen and the deep cerebral veins of the left thalamus and occipital sulcus, a complication from air being introduced into the patient via improper flushing of dialysis tubing. The retrograde flow of air bubbles in the upright patient during dialysis was likely responsible for the air embolus lodging in the cerebral vasculature. This patient was transferred to receive hyperbaric therapy, whereupon the patient survived with residual attention and spatial deficits.