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A 69-year-old man presented with a reduced level of consciousness and left hemiparesis immediately after a percutaneous CT-guided transthoracic needle lung biopsy, performed to investigate an interstitial pulmonary disease. CT scan of the head (figure 1A, B) showed small, 1–2 mm sparse and linearly arranged hypodensities, suggesting air emboli in the anterior and posterior territories of the right cerebral hemisphere circulation, without ischaemic lesions. However, MR brain imaging (figure 1C, D) ultimately confirmed stroke secondary to gas embolisation in the same territory. Echocardiography, carotid and vertebral arterial duplex scans, and routine laboratory tests were normal. We gave him aspirin, but his left leg weakness persisted. He died 1 year later from pulmonary complications of the primary …
Contributors DSO: case report: conception, organisation and execution; manuscript preparation: writing of the first draft, and review and critique. BDP: case report: conception, organisation and execution; manuscript preparation: writing of the first draft, and review and critique. TCV: case report: conception, organisation and execution; manuscript preparation: writing of the first draft, and review and critique. LAP: case report: conception and organisation; manuscript preparation: review and critique.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed Holgar Allroggen, Coventry, UK.