Citation

Brune JE, Kaech DL, Wyler D, Jeker R. BMJ Case Rep. 2018; 2018: bcr-2017-223545.

Affiliation

Department of Internal Medicine, Kantonsspital Graubunden, Chur, Switzerland.

Copyright

(Copyright © 2018, BMJ Publishing Group)

DOI

10.1136/bcr-2017-223545

PMID

30219774

Abstract

We present a case of a young male patient with a fatal pulmonary air embolism following a penetrating gunshot head injury. He suffered from severe head trauma including a laceration of the superior sagittal sinus. Operative neurosurgical intervention did not establish a watertight closure of the wounds. Eight days after the trauma, the patient suddenly collapsed and died after an attempt to mobilise him to the vertical. Forensic autopsy indicated pulmonary air embolism as the cause of death. Retrospectively, we postulate an entry of air to the venous system via the incompletely occluded wounds and the lacerated superior sagittal sinus while mobilisation to the vertical created a negative pressure in the dural sinus.

© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

adult intensive care; neurosurgery; trauma; trauma cns /pns