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A Case of Cerebral Air Embolism After Dental Procedure

Air embolism is a rare and life-threatening event that occurs when air enters the cardiovascular system, usually secondary to iatrogenic vascular procedures. We present a 58-year-old woman who underwent a dental procedure (devitalization of a tooth) under local anesthesia, with a sudden onset of com...

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Autores principales: David, Filipa, Castedo, João S, Prisco, Inês, França, Sara, Gonçalves, Celina, Monteiro, Sofia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019787/
https://www.ncbi.nlm.nih.gov/pubmed/36938158
http://dx.doi.org/10.7759/cureus.34976
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author David, Filipa
Castedo, João S
Prisco, Inês
França, Sara
Gonçalves, Celina
Monteiro, Sofia
author_facet David, Filipa
Castedo, João S
Prisco, Inês
França, Sara
Gonçalves, Celina
Monteiro, Sofia
author_sort David, Filipa
collection PubMed
description Air embolism is a rare and life-threatening event that occurs when air enters the cardiovascular system, usually secondary to iatrogenic vascular procedures. We present a 58-year-old woman who underwent a dental procedure (devitalization of a tooth) under local anesthesia, with a sudden onset of coma during manipulation and documentation of air in the vessels of the right frontal convexity sulci. After cerebral air embolism was confirmed, she received hyperbaric oxygen therapy, with resorption of the gas, but clinically she developed a super-refractory status epilepticus with a persistent coma. The slow clinical course required the exclusion of other etiologies of coma. The pathophysiology is not well known; however, it appears to be related to the injection of air by the high-speed dental drill through the soft tissue adjacent to the roots of the teeth, nearby the bloodstream. We highlight this event because of this unlikely association, which may delay diagnosis and the good results of hyperbaric medicine on prognosis.
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spelling pubmed-100197872023-03-17 A Case of Cerebral Air Embolism After Dental Procedure David, Filipa Castedo, João S Prisco, Inês França, Sara Gonçalves, Celina Monteiro, Sofia Cureus Anesthesiology Air embolism is a rare and life-threatening event that occurs when air enters the cardiovascular system, usually secondary to iatrogenic vascular procedures. We present a 58-year-old woman who underwent a dental procedure (devitalization of a tooth) under local anesthesia, with a sudden onset of coma during manipulation and documentation of air in the vessels of the right frontal convexity sulci. After cerebral air embolism was confirmed, she received hyperbaric oxygen therapy, with resorption of the gas, but clinically she developed a super-refractory status epilepticus with a persistent coma. The slow clinical course required the exclusion of other etiologies of coma. The pathophysiology is not well known; however, it appears to be related to the injection of air by the high-speed dental drill through the soft tissue adjacent to the roots of the teeth, nearby the bloodstream. We highlight this event because of this unlikely association, which may delay diagnosis and the good results of hyperbaric medicine on prognosis. Cureus 2023-02-14 /pmc/articles/PMC10019787/ /pubmed/36938158 http://dx.doi.org/10.7759/cureus.34976 Text en Copyright © 2023, David et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
David, Filipa
Castedo, João S
Prisco, Inês
França, Sara
Gonçalves, Celina
Monteiro, Sofia
A Case of Cerebral Air Embolism After Dental Procedure
title A Case of Cerebral Air Embolism After Dental Procedure
title_full A Case of Cerebral Air Embolism After Dental Procedure
title_fullStr A Case of Cerebral Air Embolism After Dental Procedure
title_full_unstemmed A Case of Cerebral Air Embolism After Dental Procedure
title_short A Case of Cerebral Air Embolism After Dental Procedure
title_sort case of cerebral air embolism after dental procedure
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019787/
https://www.ncbi.nlm.nih.gov/pubmed/36938158
http://dx.doi.org/10.7759/cureus.34976
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