Keywords: Gas embolism, Cerebral gas embolism, Air embolism, Neuro Intensive care, Hyperbaric oxygen therapy.
A 48-year-old male with no significant past medical history
was listed for a posterior fossa glioma excision at a neurosurgical centre. Preoperative cardiovascular workup including echocardiography was unremarkable.
Tumour resection proceeded without significant blood loss or significant intraoperative complications. There were transient fluctuations in blood pressure and end-tidal CO₂ during resection of the superior vermian component, but these were attributed to surgical manipulation and responded to routine anaesthetic adjustments.
The procedure lasted approximately four hours and was completed without overt hemodynamic instability
Post operatively after cessation of anaesthetic agents, it was noticed that the patient failed to follow commands or open his eyes spontaneously and remained unresponsive despite being haemodynamically stable and normothermic.
It was decided to shift the patient to ICU for post op investigation, management of delayed wake up and retrial at extubation.
