Shiva Priya K, Kaushal A, Lokho P, Balasubramanian N, Agrawal A, Kant S, Badetiya N. Seizure-associated venous air embolism during awake craniotomy in the supine position: A case report. World J Clin Cases 2026; 14(9): 119273 [DOI: 10.12998/wjcc.v14.i9.119273]
Corresponding Author of This Article
Ashutosh Kaushal, DM, MD, DNB, Additional Professor, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462026, Madhya Pradesh, India. drashutosh.kaushal@gmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 26, 2026 (publication date) through Mar 27, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Shiva Priya K, Kaushal A, Lokho P, Balasubramanian N, Agrawal A, Kant S, Badetiya N. Seizure-associated venous air embolism during awake craniotomy in the supine position: A case report. World J Clin Cases 2026; 14(9): 119273 [DOI: 10.12998/wjcc.v14.i9.119273]
Kandukuri Shiva Priya, Neuroanesthesiology and Neurocritical Care, All India Institute of Medical Sciences, Delhi 110029, Delhi, India
Ashutosh Kaushal, Pfokreni Lokho, Niranjani Balasubramanian, Surya Kant, Nikhil Badetiya, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal 462026, Madhya Pradesh, India
Amit Agrawal, Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal 462026, Madhya Pradesh, India
Co-first authors: Kandukuri Shiva Priya and Ashutosh Kaushal.
Author contributions: Shiva Priya K and Kaushal A are co-first authors and contributed equally to this work; Shiva Priya K and Kaushal A made the most significant intellectual contributions, including conceptualization, acquiring and analyzing data, and drafting the original manuscript; Shiva Priya K, Kaushal A, Lokho P, Balasubramanian N, Agrawal A, Kant S, and Badetiya N collected and analyzed the data; Kaushal A and Agrawal A supervised the report; The original manuscript was prepared by Shiva Priya K and Kaushal A, and it was critically reviewed and edited by Agrawal A, Balasubramanian N, and Lokho P; and all authors have read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Ashutosh Kaushal, DM, MD, DNB, Additional Professor, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462026, Madhya Pradesh, India. drashutosh.kaushal@gmail.com
Received: January 28, 2026 Revised: February 14, 2026 Accepted: March 5, 2026 Published online: March 26, 2026 Processing time: 55 Days and 16.1 Hours
Core Tip
Core Tip: Venous air embolism (VAE), though classically associated with neurosurgical procedures in the sitting position, can also occur during awake craniotomy in the supine position and may present with subtle, nonspecific symptoms. In awake patients, seizure-related deep inspiratory efforts and transient negative intrathoracic pressure can facilitate air entrainment through exposed cerebral veins, particularly when the surgical field is positioned above the level of the heart. Overlap between seizure activity and the clinical manifestations of VAE can delay recognition in the absence of advanced monitoring. This case highlights the need for heightened vigilance, early clinical suspicion, and prompt supportive management to ensure favorable outcomes during awake craniotomy.
