Teaching NeuroImages: Cerebral air embolism secondary to atrial-esophageal fistula

A 58-year-old man presented in minimally arousable state hours after experiencing right-sided paresthesias. He had a distant history of esophageal carcinoma, treated by esophagogastrectomy, local radiotherapy, and dilations. He was admitted, and the consensus diagnosis was probable infective endocarditis with embolic cerebral infarctions. He was treated …