This case suggests that venous cortical air embolism can be a hidden precursor of extensive arterial ischemia even without an intracardiac right-to-left shunt, particularly when pulmonary filtration reserve is limited. Clinicians should maintain a high index of suspicion when new neurological deficits appear after central venous catheter manipulation, ensure meticulous preventive measures and close observation after removal, and rapidly initiate appropriate supportive treatment if venous air embolism is suspected.
Riachy et al. (Tue,) studied this question.