Multiple cerebral air emboli during upper gastrointestinal endoscopy

A 76-year-old woman, previously treated with curative chemo-radiation for a T3N1M0 squamous cell carcinoma of the oesophagus, underwent upper gastrointestinal (GI) endoscopy with high air pressure to dilate a postradiation oesophageal stricture. The procedure was performed under conscious sedation with midazolam. Immediately after, she could not move her left arm and leg. On neurological examination she had right-sided conjugate eye- and head deviation with left-sided hemianopsia and left-sided hemiparalysis of arm and leg with ipsilateral hyperreflexia and extensor plantar reflex. A brain CT …