Hyperintensity in the subarachnoid space on contrast-enhanced fluid-attenuated inversion-recovery magnetic resonance imaging after central venous catheter removal.

Cerebral air embolism is a rare complication of central venous catheterization. A 61-year-old man developed a left-sided hemiparesis immediately after his right jugular venous catheter removal. A diffusion-weighted magnetic resonance imaging (MRI) obtained 2 h after the symptom onset was normal. However, postgadolinium cerebral spinal fluid enhancement was seen on fluid-attenuated inversion-recovery MRI. A repeat diffusion-weighted MRI, 18 h later, showed restricted diffusion in the bilateral hemispheres. Disruption of the blood-brain barrier caused by the air bubbles might lead to accumulation of gadolinium in the subarachnoid space. Postgadolinium cerebral spinal fluid enhancement may be an early, sensitive predictor of blood-brain barrier disruption and impending cerebral infarct after air embolism.