Arterial cerebral air embolism occurred during root canal treatment: a case report and literature review

Beibei Ge; Xinqiang Zhu; Yingxin Ju; Yannan Ma; Yong Song

doi:10.2478/abm-2026-0015

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Arterial cerebral air embolism occurred during root canal treatment: a case report and literature review

Asian Biomedicine

Volume 20 (2026): Issue 2 (April 2026)

By: Beibei Ge, Xinqiang Zhu, Yingxin Ju, Yannan Ma and Yong Song

Open Access

|Apr 2026

Abstract

Background

Root canal treatment is generally safe, but cerebral arterial air embolism (CAAE) is a rare, life-threatening complication.

Case presentation

A 69-year-old male with apical periodontitis of teeth #31 and #41 suffered sudden loss of consciousness and coma during endodontic treatment. Cerebral computed tomography (CT) revealed multiple intracranial punctate gas densities with cervical and maxillofacial subcutaneous emphysema. Hyperbaric oxygen therapy (HBOT) led to complete neurological recovery.

Conclusion

Clinicians must recognise the risk of arterial air embolism from high-pressure air syringes. Prevention hinges on minimising air pressure and duration, using the lowest effective pressure, and ensuring meticulous haemostasis. Acute neurological deterioration demands immediate imaging and urgent HBOT. Integrating these measures into dental safety standards is essential.

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Articles in this issue

DOI: https://doi.org/10.2478/abm-2026-0015 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415

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Language: English

Page range: 142 - 146

Published on: Apr 30, 2026

Published by: Chulalongkorn University

In partnership with: Paradigm Publishing Services

Publication frequency: 6 issues per year

Keywords:

air embolism,

arterial,

cerebral air embolism,

endodontic,

root canal therapy

Related subjects:

Medicine,

Assistive professions, nursing,

Basic medical science,

Basic medical science, other,

Clinical medicine,

Clinical medicine, other

© 2026 Beibei Ge, Xinqiang Zhu, Yingxin Ju, Yannan Ma, Yong Song, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 20 (2026): Issue 2 (April 2026)