Paradoxical cerebral embolisation

Paradoxical cerebral embolisation. An explanation for fat embolism syndrome.

Fat embolism occurs following fractures of a long bone or arthroplasty. We investigated whether paradoxical embolisation through a venous-to-arterial circulation shunt (v-a) could lead to cerebral embolisation during elective hip or knee arthroplasty. Transcranial Doppler ultrasound (TCD), following the intravenous injection of microbubble contrast, identified the presence of a shunt in 41 pati...

Paradoxical hyperfixation of HMPAO in cerebral infarction.

A paradoxical cerebral hemodynamic effect of hydralazine.

Hydralazine is shown to have a very complex cerebral hemodynamic effect. It raises the intracranial pressure which, together with its effect upon systemic blood pressure, reduces the cerebral perfusion pressure. In spite of this and a concomitantly induced hyperventilation by hydralazine, CBF increases with some delay. The conclusion is that hydralazine is a cerebral vasodilator acting immediat...

Cerebral arteriovenous malformation in a neonate: treatment by embolisation.

A neonate with an aneurysm of the vein of Galen was treated by embolisation using Giant-urco coils. Doppler ultrasound examination showed that blood flow in the internal carotid artery decreased while that in the pericallosal artery increased after occlusion, suggesting a 'steal phenomenon' with blood directed preferentially towards the aneurysm.

Septic Cerebral Embolisation in Fulminant Mitral Valve Infective Endocarditis

A 37-year-old male with known intravenous drug use was admitted with an acute onset of worsening confusion and speech impairment. His vitals and biochemical profile demonstrated severe sepsis, with a brain CT showing several lesions suspicious for cerebral emboli. He then went on to have a bedside transthoracic echocardiogram that was positive for vegetation on the mitral valve, with associated...