We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Images in Neurology |

Air Embolism With Pneumocephalus

Nicole A. Cipriani, MD; Cheng Hong, MD, PhD; Jordan Rosenblum, MD; Peter Pytel, MD
Arch Neurol. 2009;66(9):1172-1173. doi:10.1001/archneurol.2009.171.
Text Size: A A A
Published online


A 68-year-old woman with a history of poorly differentiated non–small-cell lung cancer underwent bronchoscopy because of coughing to look for possible recurrent disease. The procedure was complicated by severe pulmonary hemorrhage resulting in a blood loss of 1 to 2 L and cardiac arrest with pulseless electrical activity. Cardiopulmonary resuscitation was successful. On the following day she was found to have bilaterally dilated pupils. A head computed tomography scan demonstrated diffuse air embolism with pneumocephalus. Air was seen in the intracranial vasculature, subarachnoid, and intraparenchymal spaces (Figure 1). The patient died that same day. The subsequent autopsy confirmed recurrent carcinoma invading the tracheobronchial wall and pulmonary vasculature. The brain demonstrated multiple cavities of up to 3 cm corresponding to the imaging finding of intraparenchymal air. The cystic cavities did not show any postmortem bacterial growth but were associated with patchy acute ischemic injury in the cerebral cortex and petechial hemorrhages in white matter. The autopsy findings support and illustrate the diagnosis of air embolism and pneumocephalus with secondary infarction (Figure 2).

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Computed tomography images showing extensive air accumulation within intracranial blood vessels and in the form of localized intraparenchymal accumulations.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Autopsy specimen showing large intraparenchymal spaces corresponding to the gas accumulation visualized by computed tomography. There are also petechial hemorrhages and acute hypoxic changes with mottled gray discoloration of the cerebral cortex and focal blurring of the junction between cortical gray and white matter.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

4 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles