Paradoxical and Retrograde Air Embolism from Pressurized Peripheral Bolus

Figure 1

(a, b) Computerized tomography (CT) of the brain axial sections showing air embolism in the cortical branches of the posterior cerebral, middle, and anterior cerebral arteries, respectively (white arrows). (c) Same CT scan showing air in the superior sagittal sinus and cortical veins (black arrow). (d) CT scan showing air in the bilateral cavernous sinus (black arrow). (e, f) Diffusion-weighted sequence of a magnetic resonance image of the brain showing diffuse bilateral cortical anoxic injury. (g, h) TTE showing tricuspid valve vegetation (white arrow) and location of interatrial septum and PFO, respectively (white arrowhead). Bubbles in the left atrium and ventricle that crossed within 3 cardiac cycles.

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