Air in the right ventricle and vein after basilar skull fracture: a case report
Abstract Background Air in the venous system may cause vascular air embolism, which is a potentially life-threatening event. The presence of air in venous system after basilar skull fracture is very rare. Case presentation A 77-year-old man fell from a truck bed and suffered head and neck trauma. On...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12245-020-00326-5 |
| _version_ | 1830093356576800768 |
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| author | Hiroki Kai Tomoya Hirose Takaya Nishiura Takashi Noma Yoshihito Ogawa Tomoki Yamada Haruhiko Nakae Yasuaki Mizushima |
| author_facet | Hiroki Kai Tomoya Hirose Takaya Nishiura Takashi Noma Yoshihito Ogawa Tomoki Yamada Haruhiko Nakae Yasuaki Mizushima |
| author_sort | Hiroki Kai |
| collection | DOAJ |
| description | Abstract Background Air in the venous system may cause vascular air embolism, which is a potentially life-threatening event. The presence of air in venous system after basilar skull fracture is very rare. Case presentation A 77-year-old man fell from a truck bed and suffered head and neck trauma. On hospital arrival, his consciousness was clear and his vital signs were stable. His chief complaint was pain in the back of his head and neck. Head CT showed traumatic subarachnoid hemorrhage in the right frontal area and basilar skull fracture of the occipital bone. Whole body CT showed pneumocephalus and air in the jugular vein and right ventricle. The patient was placed in the supine position in a state of absolute rest to prevent vascular air embolism and was treated conservatively. On hospital day 3, CT was reperformed, revealing disappearance of air in the right ventricle and decreased air in the veins of the head and neck. On hospital day 4, the air in the veins disappeared completely on CT. He did not experience vascular air embolism after increasing of his activity level (e.g., raising his head on hospital day 3 and standing and walking alone on day 5). He was discharged 34 days after admission without sequelae. Conclusions Head trauma patients with basilar skull fracture might develop vascular air embolism if physicians fail to detect air in the venous system on hospital arrival. A high degree of suspicion regarding air in venous system or heart is required when patients present with such injuries. |
| first_indexed | 2024-12-16T17:52:24Z |
| format | Article |
| id | doaj.art-e47ec2e44eb14851ac105d94cc6f12a3 |
| institution | Directory Open Access Journal |
| issn | 1865-1372 1865-1380 |
| language | English |
| last_indexed | 2024-12-16T17:52:24Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-e47ec2e44eb14851ac105d94cc6f12a32022-12-21T22:22:16ZengBMCInternational Journal of Emergency Medicine1865-13721865-13802020-11-011311310.1186/s12245-020-00326-5Air in the right ventricle and vein after basilar skull fracture: a case reportHiroki Kai0Tomoya Hirose1Takaya Nishiura2Takashi Noma3Yoshihito Ogawa4Tomoki Yamada5Haruhiko Nakae6Yasuaki Mizushima7Emergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalEmergency and Critical Care Medical Center, Osaka Police HospitalAbstract Background Air in the venous system may cause vascular air embolism, which is a potentially life-threatening event. The presence of air in venous system after basilar skull fracture is very rare. Case presentation A 77-year-old man fell from a truck bed and suffered head and neck trauma. On hospital arrival, his consciousness was clear and his vital signs were stable. His chief complaint was pain in the back of his head and neck. Head CT showed traumatic subarachnoid hemorrhage in the right frontal area and basilar skull fracture of the occipital bone. Whole body CT showed pneumocephalus and air in the jugular vein and right ventricle. The patient was placed in the supine position in a state of absolute rest to prevent vascular air embolism and was treated conservatively. On hospital day 3, CT was reperformed, revealing disappearance of air in the right ventricle and decreased air in the veins of the head and neck. On hospital day 4, the air in the veins disappeared completely on CT. He did not experience vascular air embolism after increasing of his activity level (e.g., raising his head on hospital day 3 and standing and walking alone on day 5). He was discharged 34 days after admission without sequelae. Conclusions Head trauma patients with basilar skull fracture might develop vascular air embolism if physicians fail to detect air in the venous system on hospital arrival. A high degree of suspicion regarding air in venous system or heart is required when patients present with such injuries.https://doi.org/10.1186/s12245-020-00326-5Basilar skull fractureAir embolismRight ventricleJugular vein |
| spellingShingle | Hiroki Kai Tomoya Hirose Takaya Nishiura Takashi Noma Yoshihito Ogawa Tomoki Yamada Haruhiko Nakae Yasuaki Mizushima Air in the right ventricle and vein after basilar skull fracture: a case report International Journal of Emergency Medicine Basilar skull fracture Air embolism Right ventricle Jugular vein |
| title | Air in the right ventricle and vein after basilar skull fracture: a case report |
| title_full | Air in the right ventricle and vein after basilar skull fracture: a case report |
| title_fullStr | Air in the right ventricle and vein after basilar skull fracture: a case report |
| title_full_unstemmed | Air in the right ventricle and vein after basilar skull fracture: a case report |
| title_short | Air in the right ventricle and vein after basilar skull fracture: a case report |
| title_sort | air in the right ventricle and vein after basilar skull fracture a case report |
| topic | Basilar skull fracture Air embolism Right ventricle Jugular vein |
| url | https://doi.org/10.1186/s12245-020-00326-5 |
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