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Case Reports
. 2018 Mar 14:2018:9496818.
doi: 10.1155/2018/9496818. eCollection 2018.

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

Lawrence Lau  1 , Kory London  1
Affiliations
Case Reports

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

Lawrence Lau et al. Case Rep Emerg Med. .

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.

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Figures

Figure 1
Figure 1
Multiple punctate and curvilinear foci of hypoattenuation in the left hemisphere, likely air within vascular structures given recent hemodialysis (gold arrows).
See this image and copyright information in PMC

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