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Venous Air Embolism

Last Updated: September 27, 2018

Frontal GBM: Incision, Craniotomy, Burr Hole Placement and Managing Venous Air Embolism

Pathogenesis of Venous Air Embolism

A number of neurosurgical complications depend on the patient’s position during surgery and air embolism is an exemplar. Its development depends on the angle of the patient’s head relative to the operative site and the heart. The negative pressure gradient between the patient’s elevated head and the dependent right atrium creates an opportunity for air to siphon through the veins.

Dehydration and blood loss increase the risk of venous air embolism because they decrease central venous pressure. Depending on the patient series, the incidence can reach as high as 60%, mostly asymptomatic, while the associated mortality and morbidity is less than 3%.

The use of the sitting position for the patient during a posterior fossa operation offers numerous advantages, including an optimally clear operative field through...