Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report
Introduction Ischaemic stroke, primarily caused by thromboembolic events, typically arises as a consequence of underlying vascular or cardiac pathology. Non-thrombotic embolic strokes, although rare, are increasingly seen in interventional and intravascular procedures. Oxygen-ozone therapy (OOT) is...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Neurology Open |
| Online Access: | https://neurologyopen.bmj.com/content/6/2/e000885.full |
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| author | Sepehr Khosravi Zahra Mirzaasgari |
| author_facet | Sepehr Khosravi Zahra Mirzaasgari |
| author_sort | Sepehr Khosravi |
| collection | DOAJ |
| description | Introduction Ischaemic stroke, primarily caused by thromboembolic events, typically arises as a consequence of underlying vascular or cardiac pathology. Non-thrombotic embolic strokes, although rare, are increasingly seen in interventional and intravascular procedures. Oxygen-ozone therapy (OOT) is one of the popular treatments for lumbar disc herniation, providing pain relief. However, it has been linked to gas embolisms, posing severe risks. This article details a case of cerebral gas embolism and multifocal acute ischaemic stroke that occurred during OOT for lumbar disc herniation pain relief.Case presentation We present a case of a 58-year-old woman with acute onset limb weakness and speech disturbance that happened during a lumbar intradiscal oxygen-ozone injection session. Brain CT and MRI scans showed multiple cerebral gas embolisms and diffusion-restricted areas in both cerebral hemispheres. Echocardiography revealed a patent foramen ovale, hinting at a conduit for paradoxical embolism. Follow-up of the patient after 1 year showed significant improvement.Conclusion OOT, as a popular treatment for chronic pain, has been associated with severe adverse events. When facing cases of acute postoperative or postinterventional encephalopathy or stroke, arterial cerebral gas embolism should be considered a possibility. The presence of intracardiac defects or intrapulmonary shunts paves the way for paradoxical emboli to happen, resulting in a higher chance of neurological complications. |
| format | Article |
| id | doaj-art-2b65f9d4109c402ab547834f4dfda85d |
| institution | Kabale University |
| issn | 2632-6140 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Neurology Open |
| spelling | doaj-art-2b65f9d4109c402ab547834f4dfda85d2024-12-18T16:00:34ZengBMJ Publishing GroupBMJ Neurology Open2632-61402024-12-016210.1136/bmjno-2024-000885Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case reportSepehr Khosravi0Zahra Mirzaasgari14 Medicine, Iran University of Medical Sciences, Tehran, The Islamic Republic of IranDepartment of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, IranIntroduction Ischaemic stroke, primarily caused by thromboembolic events, typically arises as a consequence of underlying vascular or cardiac pathology. Non-thrombotic embolic strokes, although rare, are increasingly seen in interventional and intravascular procedures. Oxygen-ozone therapy (OOT) is one of the popular treatments for lumbar disc herniation, providing pain relief. However, it has been linked to gas embolisms, posing severe risks. This article details a case of cerebral gas embolism and multifocal acute ischaemic stroke that occurred during OOT for lumbar disc herniation pain relief.Case presentation We present a case of a 58-year-old woman with acute onset limb weakness and speech disturbance that happened during a lumbar intradiscal oxygen-ozone injection session. Brain CT and MRI scans showed multiple cerebral gas embolisms and diffusion-restricted areas in both cerebral hemispheres. Echocardiography revealed a patent foramen ovale, hinting at a conduit for paradoxical embolism. Follow-up of the patient after 1 year showed significant improvement.Conclusion OOT, as a popular treatment for chronic pain, has been associated with severe adverse events. When facing cases of acute postoperative or postinterventional encephalopathy or stroke, arterial cerebral gas embolism should be considered a possibility. The presence of intracardiac defects or intrapulmonary shunts paves the way for paradoxical emboli to happen, resulting in a higher chance of neurological complications.https://neurologyopen.bmj.com/content/6/2/e000885.full |
| spellingShingle | Sepehr Khosravi Zahra Mirzaasgari Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report BMJ Neurology Open |
| title | Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report |
| title_full | Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report |
| title_fullStr | Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report |
| title_full_unstemmed | Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report |
| title_short | Cerebral gas embolism and multifocal ischemic stroke during oxygen-ozone therapy: a case report |
| title_sort | cerebral gas embolism and multifocal ischemic stroke during oxygen ozone therapy a case report |
| url | https://neurologyopen.bmj.com/content/6/2/e000885.full |
| work_keys_str_mv | AT sepehrkhosravi cerebralgasembolismandmultifocalischemicstrokeduringoxygenozonetherapyacasereport AT zahramirzaasgari cerebralgasembolismandmultifocalischemicstrokeduringoxygenozonetherapyacasereport |