A Typical Case of Paradox Cerebral Embolism during Cemented Total Hip Arthroplasty

The procedure was performed under general anaesthesia. Both cup and stem were cemented. While implanting the cemented stem the heart beat raised from 60bpm to 95bpm and the blood pressure dropped to 90/45mmHg (Figure 2). To the end of the procedure the patient had recovered and was extubated showing stable vitals. After surgery a slurred speech and a deviation of the eyes were observed. The MRI (1,5 T, T1w SE sagittal, FLAIR coronar, T2w TSE transversal, bleedingand diffusions sensitive sequences T2w TSE sagittal TOF angiography and secondary multiplanar reconstructions) showed multiple ischemic regions in the dorsal flow area of the cerebellum on both sides, especially in the pica flow area, the left thalamus, left temporal and occipital due to multiple embolisms (Figure 3). Space occupying cerebral edema was not found.