Arterial
gas embolism can be caused by direct entry of gas into systemic arteries or indirectly by venous-to-arterial shunting. Although arterial
gas embolism is rare, most documented cases are iatrogenic, resulting from the entry of gas during procedures that involve direct vascular cannulation or intracavitary air insufflation. Of the 18 identified case reports of
air embolism during endoscopy, 11 cases describe findings of cerebral arterial
gas embolism during upper endoscopy. Only 1 of these occurred during endoscopic balloon dilation of an
esophageal stricture. We report a rare case of cerebral arterial
gas embolism in a 64-year-old woman, which occurred during endoscopic dilation of an
esophageal stricture and was subsequently treated with
hyperbaric oxygen therapy. In this case report, we explore the possible etiologies, clinical workup, and therapeutic management of cerebral artery
gas embolisms.
Hyperbaric oxygen therapy is the treatment of choice for cerebral arterial
gas embolism, with earlier treatments resulting in better outcomes.