Background: Venous air embolism (VAE) is a serious potential complication of neurosurgical procedures. Stereotactic biopsies can also cause VAE; therefore, we evaluated VAE patients to call attention to the risk of VAE associated with stereotactic biopsies.
Methods: In this report, symptomatic VAE was defined as paroxysmal coughing with associated symptoms. Air in the dural sinus, cortical vein and/or pterygoid plexus on postoperative computed tomography (CT) scans was considered to be a radiographic VAE.
Results: Three patients developed symptomatic VAE following 36 stereotactic biopsies, and the incidence of symptomatic VAE was 8.3 % (3/36). There were five patients with evidence of radiographic VAE on postoperative CT scans, with an incidence of 13.8 % (5/36). A high angle of the head seemed to be associated with VAE, allowing air to flow into the central venous system.
Conclusions: The present report emphasizes that VAE should be recognized as an important adverse effect of stereotactic biopsies because VAE occasionally requires additional treatment and/or termination of surgery. Surgeons must be aware of the possibility of VAE, especially when it is necessary to position the patient's head at a high angle.