Bubbles are introduced to the arterial circulation in many patients undergoing cardiac surgical procedures, and some of these distribute to the cerebral vessels. Larger bubbles may arrest in cerebral arterioles, causing ischemia and neuronal injury in the downstream territory. Smaller bubbles may redistribute through the cerebral circulation, but this is not a benign event. Their passage may ca...

OBJECTIVES This study sought to assess the timing of cerebral ischemia after emboli-protected carotid artery stenting (CAS). BACKGROUND Predominantly clinically silent cerebral ischemia has been observed in up to 50% of patients undergoing emboli-protected CAS. The timing and location of cerebral ischemia has not been sufficiently elucidated. METHODS In 58 patients (69.6 +/- 8.3 years) who ...

BACKGROUND AND PURPOSE Transcranial Doppler ultrasound can detect circulating cerebral emboli. Monitoring of patients with potential embolic sources may allow identification of high-risk patients who can then be selected for prophylactic treatment. However, practical patient monitoring will require automated programs that can detect emboli and differentiate them from artifact. METHODS A new o...

We present a case report of cerebral and spinal air embolism following percutaneous nephrolithotomy in a patient without evidence of intra-cardiac defects or prepulmonary A-V shunts. The position of the patient during the incidence determined the site of eventual lodgement of air emboli in the arterial circulation. We suspect that the time of onset of symptoms following the procedure may be the...

Multiple cerebral petechiae associated with intravascular globules of neutral fat and localized primarily within the white matter are distinctive lesions which secure the pathologic diagnosis of cerebral fat embolism. The abundance of these lesions in an unknown, but presumably small, percentage of cases of fat embolism, along with the even more widespread distribution of embolic fat droplets t...

Adenosine diphosphate (8 mg per minute for five minutes) was infused into the carotid artery of 63 rabbits. The effects were twofold: systemic hypotension and platelet aggregation in the cerebral circulation. As a consequence of the last effect, platelet emboli were produced which occluded cerebral arteries in a number and size sufficient to cause cerebral ischemia. Areas of focal ischemia were...

Cerebral fat embolism syndrome (CFES) is a neurologic syndrome occurring in up to 60% of patients with fat embolism syndrome (FES). The defining features of FES include respiratory, neurologic and dermatologic features. The classical explanation is release of fat emboli into the circulation after long bone fractures, but the clinical syndrome of FES only occurs in 0.5-3% of cases, typically wit...