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Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation

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Abstract

Purpose

The aim of this study was to investigate cerebral gas embolism (GE) on nontraumatic postmortem CT (PMCT), regarding its frequency, location (arterial or venous), and causes.

Materials and methods

Our subjects were 404 nontraumatically deceased patients who had been in a state of cardiopulmonary arrest on arrival at our emergency room. PMCT was performed within 2 h of the confirmation of death.

Results

Cardiopulmonary resuscitation (CPR) was performed on 387 of the 404 subjects; and of these, cerebral GE was detected in 29 (7.5%) subjects (3 arterial, 25 venous, 1 undeterminable). Cerebral GE was not noted in the other 17 of the 404 subjects who did not undergo CPR. However, there was no significant difference in the incidence of cerebral GE between the subjects who underwent CPR and those who did not. The mechanism of cerebral arterial GE was presumed due to pulmonary barotrauma and/or paradoxical embolism, while the thoracic pump theory was suggested to explain the cerebral venous GE.

Conclusion

Cerebral arterial/venous GE is found in CPR cases on nontraumatic PMCT.

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Author information

Authors and Affiliations

  1. Department of Radiology, Tsukuba Medical Center, 1-3-1 Amakubo, Tsukuba, 305-8558, Japan

    Seiji Shiotani

  2. Department of Critical Care and Emergency Medicine, Tsukuba Medical Center, Tsukuba, Japan

    Yukihiro Ueno, Shigeru Atake & Mototsugu Kohno

  3. Department of General Internal Medicine, Tsukuba Medical Center, Tsukuba, Japan

    Masatsune Suzuki

  4. Department of Pathology, Tsukuba Medical Center, Tsukuba, Japan

    Kazunori Kikuchi

  5. Department of Forensic Medicine, Tsukuba Medical Examiner’s Office, Tsukuba, Japan

    Hideyuki Hayakawa

Authors
  1. Seiji Shiotani
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  2. Yukihiro Ueno
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  4. Mototsugu Kohno
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  5. Masatsune Suzuki
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  7. Hideyuki Hayakawa
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Correspondence to Seiji Shiotani.

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Shiotani, S., Ueno, Y., Atake, S. et al. Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation. Jpn J Radiol 28, 1–7 (2010). https://doi.org/10.1007/s11604-009-0372-x

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  • DOI: https://doi.org/10.1007/s11604-009-0372-x

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