Cerebral Lipiodol Embolism after interventional lymphatic embolization

Piet Waelkens M.D, Sofian Bouneb M.D, Johan Vandommele M.D.

An infant with a medical history of an univentricular heart developed plastic fibrosis after a Fontan circuit correction. A lymphatic embolization was performed for symptomatic improvement. After one hour on the postanesthesia care unit (PACU), the patients mental status altered and had seizures. Neuroimaging revealed multiple hyper densities in the brain due to Lipiodol embolization. Cerebral Lipiodol embolism is a rare but potentially lethal complication following interventional lymphatic procedures. This case is unique due to its severity of the embolisms. Attention should be paid on postoperative neurological exam and prolonged PACU stay is advised.