Pneumatosis intracranialis: a rare association of cerebral air embolism and mesenteric ischemia

• Published in: Arquivos de neuro-psiquiatria Vol. 79; no. 12; p. 1
• Main Authors: PADILHA, Igor Gomes, PEREIRA, Helena Alves Costa, PEREIRA, Flávia Fajardo Linhares, ZACHARIAS, Sérgio, ROCHA, Antônio José da
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01.12.2021; Arquivos de Neuro-Psiquiatria; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Computed tomography; Embolism; Embolism, Air - diagnostic imaging; Embolism, Air - etiology; Humans; Ischemia; Mesenteric Ischemia; Tomography, X-Ray Computed
• ISSN: 0004-282X; 1678-4227
• DOI: 10.1590/0004-282X-ANP-2021-0285

A 67-year-old man presented with tetraparesis, which evolved rapidly into tetraplegia, and hyporeflexia and had decreased level of consciousness. Cranial and abdominal computed tomography showed an intriguing association of mesenteric ischemia with pneumatosis intestinalis and intracranial air content in subarachnoid veins. This rarely reported association has been attributed to the ascension of air through the venous system when the central venous pressure is negative relative to the atmospheric pressure, it can trigger off a coagulation cascade resulting in impaired cerebral perfusion1. The term pneumatosis intracranialis is herein proposed to describe this imaging abnormality in association with the description of air content in the bowel wall.