Iatrogenic cerebral air embolism revealing an atrial-esophageal fistula.
(2017) Internal and Emergency Medicine — Vol. 12, n° 5, p. 715-716 (2017)
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- (en) A 69-year-old man was admitted with sepsis and stroke. Thirty days prior to admission, he had undergone percutaneous radiofrequency ablation (RFA) for atrial fibrillation (AF) in another hospital. Due to sinus-atrial node disease, an internal pacemaker was inserted after the procedure. He was anticoagulated with acenocoumarol, and had a slightly supra therapeutic international normalized ratio (INR) documented recently. Three hours prior to this admission, he was found with a transient loss of consciousness, generalized tremors, and right-sided weakness. Clinical examination in the emergency department disclosed right flaccid hemiplegia and a high fever (39.5 °C). He was fully conscious, and the neck was supple. A head computed tomography (CT scan) was consistent with an ischemic stroke (left thalamic and right cerebellar low density foci). Due to activity consistent with a seizure, levetiracetam (1000 mg, twice daily) was initiated. [...]
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Wuestenberghs, F., Pirson, N., Bulpa, P., Fervaille, C., & Dive, A.-M. (2017). Iatrogenic cerebral air embolism revealing an atrial-esophageal fistula. Internal and Emergency Medicine, 12(5), 715-716. https://doi.org/10.1007/s11739-016-1561-0 (Original work published 2017)