Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation

Massive cerebral and spinal gas embolism occurs rarely as a complication of discectomy. We report a 54-year-old female who had undergone a discectomy (L3/4 and L4/5) under epidural anesthesia in a local hospital developed multiple massive gas embolisms. At closure, surgeons irrigated the incision wo...

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Main Authors: Junjie Zhang, Chengliang Zhang, Jianqin Yan
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2015/497340
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author Junjie Zhang
Chengliang Zhang
Jianqin Yan
author_facet Junjie Zhang
Chengliang Zhang
Jianqin Yan
author_sort Junjie Zhang
collection DOAJ
description Massive cerebral and spinal gas embolism occurs rarely as a complication of discectomy. We report a 54-year-old female who had undergone a discectomy (L3/4 and L4/5) under epidural anesthesia in a local hospital developed multiple massive gas embolisms. At closure, surgeons irrigated the incision wound with hydrogen peroxide. Soon after the irrigation, the patient suddenly developed tachycardia, hypotension, and rapid oxygen desaturation. Subsequently, patient progressed into unconsciousness and right hemianopsia quadriplegia. Computed tomography (CT) scan showed multiple hypointensity spots around the brain due to cerebral gas embolism, which indicated the pneumoencephalos. The likely mechanism was the absorption of hydrogen peroxide into blood. When the amount of oxygen evolved exceeded its maximal blood solubility, venous embolization occurred. Though the patient was treated with supportive treatments and hyperbaric oxygen, she did not get full recovery and was left with severe long-term cerebral injury.
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institution Kabale University
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spelling doaj-art-6d3b27bf10ba437eb94a4f58d99823492025-08-20T03:33:51ZengWileyCase Reports in Neurological Medicine2090-66682090-66762015-01-01201510.1155/2015/497340497340Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide IrrigationJunjie Zhang0Chengliang Zhang1Jianqin Yan2Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, ChinaDepartment of Cardiothoracic Surgery, Xiangya Hospital, Central South University, Changsha 410008, ChinaDepartment of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, ChinaMassive cerebral and spinal gas embolism occurs rarely as a complication of discectomy. We report a 54-year-old female who had undergone a discectomy (L3/4 and L4/5) under epidural anesthesia in a local hospital developed multiple massive gas embolisms. At closure, surgeons irrigated the incision wound with hydrogen peroxide. Soon after the irrigation, the patient suddenly developed tachycardia, hypotension, and rapid oxygen desaturation. Subsequently, patient progressed into unconsciousness and right hemianopsia quadriplegia. Computed tomography (CT) scan showed multiple hypointensity spots around the brain due to cerebral gas embolism, which indicated the pneumoencephalos. The likely mechanism was the absorption of hydrogen peroxide into blood. When the amount of oxygen evolved exceeded its maximal blood solubility, venous embolization occurred. Though the patient was treated with supportive treatments and hyperbaric oxygen, she did not get full recovery and was left with severe long-term cerebral injury.http://dx.doi.org/10.1155/2015/497340
spellingShingle Junjie Zhang
Chengliang Zhang
Jianqin Yan
Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation
Case Reports in Neurological Medicine
title Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation
title_full Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation
title_fullStr Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation
title_full_unstemmed Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation
title_short Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation
title_sort massive cerebral gas embolism under discectomy due to hydrogen peroxide irrigation
url http://dx.doi.org/10.1155/2015/497340
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AT chengliangzhang massivecerebralgasembolismunderdiscectomyduetohydrogenperoxideirrigation
AT jianqinyan massivecerebralgasembolismunderdiscectomyduetohydrogenperoxideirrigation