Intraparenchymal hemorrhage related to cerebral venous air embolism secondary to mesenteric ischemia
INTRODUCTION: The presence of air in vascular structures of the brain can lead to neurological symptoms and significant morbidity. It usually occurs as a consequence of invasive therapeutic procedures and is very rarely triggered by any other cause.
CASE REPORT: We report the case of a 76-year-old woman with a history of atrial fibrillation anticoagulated with acenocoumarol who visited the Emergency department because of sudden-onset abdominal pain, vomiting and diarrhoea. After starting symptomatic treatment and finding analytical evidence of underdosing of the anticoagulant, she suddenly presented with neurological focus. A cranial computed tomography scan revealed an acute intraparenchymal haemorrhage. The patient was transferred to the stroke unit of the referral hospital. Within a few hours, she developed haemodynamic instability due to a septic shock that had its origin in the abdomen. A computed tomography scan of the abdomen evidenced extensive pneumatosis intestinalis and an obstruction of contrast indicating mesenteric ischaemia. A mechanical thrombectomy was performed in an attempt to embolise the thrombus at a more distal level, but the patient died.
CONCLUSIONS: Mesenteric ischaemia can cause significant pneumatosis intestinalis, which, by a retrograde mechanism through the portal system, can cause air bubbles to reach the cerebral venous system, leading to acute stroke.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:72 |
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| Enthalten in: |
Revista de neurologia - 72(2021), 9 vom: 01. Mai, Seite 333-335 |
| Sprache: |
Spanisch |
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| Weiterer Titel: |
Hemorragia intraparenquimatosa relacionada con embolismo venoso secundario a isquemia mesentérica |
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| Beteiligte Personen: |
Alba-Isasi, M T [VerfasserIn] |
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| Anmerkungen: |
Date Completed 20.01.2022 Date Revised 20.01.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.33588/rn.7209.2020652 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM324619863 |
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| 245 | 1 | 0 | |a Intraparenchymal hemorrhage related to cerebral venous air embolism secondary to mesenteric ischemia |
| 246 | 3 | 3 | |a Hemorragia intraparenquimatosa relacionada con embolismo venoso secundario a isquemia mesentérica |
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| 500 | |a Date Completed 20.01.2022 | ||
| 500 | |a Date Revised 20.01.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: The presence of air in vascular structures of the brain can lead to neurological symptoms and significant morbidity. It usually occurs as a consequence of invasive therapeutic procedures and is very rarely triggered by any other cause | ||
| 520 | |a CASE REPORT: We report the case of a 76-year-old woman with a history of atrial fibrillation anticoagulated with acenocoumarol who visited the Emergency department because of sudden-onset abdominal pain, vomiting and diarrhoea. After starting symptomatic treatment and finding analytical evidence of underdosing of the anticoagulant, she suddenly presented with neurological focus. A cranial computed tomography scan revealed an acute intraparenchymal haemorrhage. The patient was transferred to the stroke unit of the referral hospital. Within a few hours, she developed haemodynamic instability due to a septic shock that had its origin in the abdomen. A computed tomography scan of the abdomen evidenced extensive pneumatosis intestinalis and an obstruction of contrast indicating mesenteric ischaemia. A mechanical thrombectomy was performed in an attempt to embolise the thrombus at a more distal level, but the patient died | ||
| 520 | |a CONCLUSIONS: Mesenteric ischaemia can cause significant pneumatosis intestinalis, which, by a retrograde mechanism through the portal system, can cause air bubbles to reach the cerebral venous system, leading to acute stroke | ||
| 650 | 4 | |a Case Reports | |
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| 700 | 1 | |a Sánchez-Serrano, I |e verfasserin |4 aut | |
| 700 | 1 | |a Escribano-Paredes, B |e verfasserin |4 aut | |
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