Air Emboli in the Intracranial Venous Sinuses of Neonates

ABSTRACT

Air bubbles in the intracranial venous sinuses are known as a consequence to different causes including trauma, infection, and administration of intravenous contrast. Most of the previous reports demonstrated such cases in adults, with subsequent complications. We are presenting two premature babies who developed asymptomatic air bubbles in the right cavernous and left transverse sinuses, introduced accidentally upon cannulation of scalp veins. In both babies the air embolism disappeared in a few days without complications. Our cases suggest that these accidents could happen more frequently in neonates following scalp vein cannulation, which is a common procedure in sick babies, but they were overlooked as the outcome was uneventful. However, the precise nature and clinical significance of this lesion is not well understood in neonates.

KEYWORD

Air emboli - venous sinuses - neonates

REFERENCES

• 1 Curnes J T, Creasy J K, Whaley R L, Scatliff J H. Air in the cavernous sinus: a new sign of septic cavernous sinus thrombosis.  Am J Neuroradiol . 1987;  8 176-177
• 2 Rubinstein R, Symonds D. Gas in the cavernous sinus.  Am J Neuroradiol . 1994;  15 561-566
• 3 Bartynski W S, Wang A. Cavernous sinus air in a patient with basilar skull fracture: CT identification.  J Comput Assist Tomogr . 1988;  12 141-142
• 4 Roberston W D, Kuno R. Cavernous sinus air following orbital trauma.  Am J Roentgenol . 1995;  164 980
• 5 Adams M, Quint D J, Eldvik O P. Iatrogenic air in the cavernous sinus.  Am J Roentgenol . 1992;  159 189-190
• 6 MacDonald M G, Eichelberger M R. Peripheral intravenous line placement. In: Fletcher MA, MacDonald MG, eds. Atlas of Procedures in Neonatology 2nd ed. Philadelphia: J.B. Lippincott 1993: 144
• 7 Gabella G. Cardiovascular. In: Williams PL, ed. Gray's Anatomy 38th ed. New York: Churchill Livingstone 1995: 1576-1589
• 8 Brook J, Moss E. Air in the cavernous sinus following scalp vein cannulation.  Anesthesia . 1994;  49 219-220
• 9 Navarrete M L, Galindo J, Pallicer M, Barcelona S. Cavernous sinus air bubble.  Ear Nose Throat J . 1990;  69 771-772
• 10 Rubinstein D, Dangleis K, Damiano T R. Venous air emboli identified on head and neck CT scans.  J Comput Assist Tomogr . 1996;  20 559-562
• 11 Hosoya R, Kera M, Suzuke T, Yamaguchi K. Fat in the normal cavernous sinus.  Neuroradiology . 1986;  28 264-266
• 12 Dendy P P, Heaton B. Physics for Radiologist 1st ed. Oxford: Blackwell Scientific Publications 1987
• 13 Orebaugh S L. Venous air embolism: clinical and experimental considerations.  Crit Care Med . 1992;  20 1169-1177