Cerebral air embolism after pleural lavage for empyema.

Percutaneous pleural maneuvers are routinely performed in the management of pleural diseases with favorable safety profile. We report a case of cerebral air embolism during a pleural lavage for the management of an empyema. This severe complication is rarely reported in the literature although it can happen after any percutaneous thoracic procedures. Asymptomatic arterial air emboli may occur in up to 5 % of percutaneous thoracic maneuvers. Diagnosis should be evoked in front of sudden neurological signs and confirmed with brain imaging. Standard treatment is based on hyperbaric oxygen therapy and can be performed safely with intra-pleural catheter.