EURORAD ESR

Case 14140

Systemic air embolism and decompression illnes in a scuba diver.

Author(s)
Barbagallo Stella, Secondini Lucia, Perugin Giulia, Bergaglio Chiara, Prono Valentina, Migone Stefania, Rosa Francesca, Basso Luca, Verardo Ilaria, Neumaier Carlo Emanuele.

IRCSS A.O.U. "San Martino" - IST, Scuola di Specializzazione in Radiodiagnostica; Via L.B. Alberti, 4 Genova, Italy; Email:lucyeah@hotmail.it
 
Patient
female, 27 year(s)
 
 
  • Figure 1
    Brain CT
     

    Unenhanced CT shows effacement of cerebral sulci.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Oedema;

    Unenhanced CT shows an area of low attenuation in the right cerebellar medium peduncle (involving the omolateral cerebellar lobe).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 2
    Gas embolism
     

    Arrow shows gas in left innominate vein.

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Embolism / Thrombosis;

    Gas in retroclavear vessels.

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Embolism / Thrombosis;

    Gas in pulmonary trunk.

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 3
    Gas embolism part II
     

    Arrow shows gas in the inferior vena cava at the confluence of the renal veins.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Embolism / Thrombosis;

    Gas in the inferior vena cava in a upper level, shortly before the outlet in the right atrium.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Embolism / Thrombosis;

    Arrow shows gas bubbles in some portal branches for the left hepatic lobe.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 4
    Brain and spine MRI
     

    MR imaging on sagittal view in T2WI with fat signal saturation. Arrow shows a linear area of hyperintensity involving the spinal cord at T8-T9 level, indicative of hypoxic suffering.

     
    Area of Interest: Neuroradiology spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    The previous MR imaging finding (T2WI), on axial view.

     
    Area of Interest: Neuroradiology spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    MR image on coronal view (FLAIR sequence) shows an increase of signal in corrispondence of the left thalamus (arrow).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;

    This MR axial scan shows the involvement of both thalami (arrows).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
Unenhanced CT shows effacement of cerebral sulci.
 
Unenhanced CT shows an area of low attenuation in the right cerebellar medium peduncle (involving the omolateral cerebellar lobe).
 
Arrow shows gas in left innominate vein.
 
Gas in retroclavear vessels.
 
Gas in pulmonary trunk.
 
Arrow shows gas in the inferior vena cava at the confluence of the renal veins.
 
Gas in the inferior vena cava in a upper level, shortly before the outlet in the right atrium.
 
Arrow shows gas bubbles in some portal branches for the left hepatic lobe.
 
MR imaging on sagittal view in T2WI with fat signal saturation. Arrow shows a linear area of hyperintensity involving the spinal cord at T8-T9 level, indicative of hypoxic suffering.
 
The previous MR imaging finding (T2WI), on axial view.
 
MR image on coronal view (FLAIR sequence) shows an increase of signal in corrispondence of the left thalamus (arrow).
 
This MR axial scan shows the involvement of both thalami (arrows).
 
 
 
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