Cerebral Air Embolism – A Rare Complication of Computed Tomography Guided Lung Biopsy

Abstract

Thoracic lesions constitute a major chunk of the conditions presenting to a pulmonologist. They comprise a panorama of assorted etiologies ranging from benign lung lesions to aggressive malignancies. A tissue biopsy and its histopathological analysis is the gold standard for diagnosis. Computed tomography (CT)-guided lung biopsy is a safe and imminent tool for obtaining a tissue biopsy of underlying thoracic pathology. However, it has its own gamut of complications. The most common complications encountered include pneumothorax, hemorrhage, hemoptysis, iatrogenic infections, and sporadically air embolism. Cerebral air embolism is a fatal complication of CT-guided lung biopsy seen in a miniscule subset of patients. It requires urgent diagnosis and prompt therapy initiation. High-flow oxygen and hyperbaric oxygen therapy are usually helpful. Due to heterogeneous presentation, it usually remains undiagnosed. A high index of suspicion and early initiation of appropriate therapy can save precious lives. We hereby report a unique case of this rarefied complication.