A catastrophic case of venous air embolism in a patient undergoing posterior fossa surgery

Ruby Guleria, Anita Sharma, Maninder Singh Raizada, Neetiksha Singh


Posterior cranial fossa surgeries pose increased risk of venous air embolism (VAE) due the associated pressure gradient. Early detection of VAE is of paramount importance to avoid the disastrous consequences. We, hereby report a case of catastrophic VAE in a 47-year-old male undergoing surgery for glioblastoma.


Air entrainment, ETCO2, Venous embolism

Full Text:



Palmon SC, Moore LE, Lundberg J, Toung TJ. Venous air embolism: A review. J Clin Anesth. 1997;9:251-57.

Black S, Ockert DB, Oliver WC, Cucchiara RF. Outcome following posterior fossa craniectomy in the sitting position vs horizontal position. Anesthesiology. 1988;69:49-56.

Albin MS, Babinski M, Maroon JC, Jannetta PJ. Anaesthetic management of posterior fossa surgery in the sitting position. Acta Anaesthesiol Scand. 1976;20:117.

Vinay B, Sriganesh K, Krishna KN. An abrupt reduction in end-tidal carbon-dioxide during neurosurgery is not always due to venous air embolism: a capnograph artefact. J Clin Monit Comput. 2013;31:5-7.

Muth CM, Shank ES. Primary care: Gas embolism. N Eng J Med. 2000;342:476-82.

Toung TJ, Rossberg MI, Hutchins GM. Volume of air in a lethal venous air embolism. Anesthesiology. 2001;94:360-1.

Shaikh N, Ummunisa F. Acute management of vascular air embolism. J Emerg Trauma Shock. 2009;2:180-5.

Jaffe RA, Siegel LC, Schnittger I, Propst JW, Brock-Utne JG. Epidural air injection associated with air embolism detected by transesophageal echocardiography. Reg Anesth. 1995;20:152-5.

Sibai AN, Baraka A, Moudawar A. Hazards of nitrous oxide administration in the presence of venous air embolism. Middle East J Anesthes. 1996;13:259-71.

Ho AM, Ling E. Systemic air embolism after lung trauma. Anesthes. 1990;90:564-75.