The clinical effect of generating microbubbles depends on their size. Bubbles larger than 200μm are of clinical importance with respect to embolic complications. By occluding capillary beds distal ischaemia of the organ supplied by this blood supply results. Micro bubbles 50-200um are initially trapped in arterioles, but are eventually displaced by blood. Transit times are in the order of 60 to 360 seconds under normal haemodynamic conditions. In the brain arterioles initially dilate, returning to normal after about 30 minutes, but this recovery is associated with a progressive fall in cerebral blood flow, reaching 50% of baseline measurements 60 minutes after exposure to air. Cortical somatosensory evoked response fall to 25% of baseline levels by the time of bubble transit, and this depression continues for several hours after exposure to air. Smaller microbubbles, less than 50μm in diameter, despite being able to cross capillary beds easily, may also produce deleterious effects. These include cellular and protein activation with the bubble–blood interface acting as a foreign surface. Bubble contact with vascular walls alters the endothelial cells that further promote release of vasoactive mediators and platelet and neutrophil adhesion. The bubble is compressed against the endothelial capillary wall, causing functional stripping of endothelial cells and an increase of large pore radii. In addition gaps between endothelial cells are created following air embolism. Normally, endothelial cells are tightly joined, preventing intravascular fluids from pouring out into the surrounding tissue. Gap formation allows leakage and resultant interstitial oedema. Therefore the generation of microemboli of any size may result in neurological deficits secondary to ischaemia or necrosis, neurocognitive dysfunction with a decrease in cerebral blood flow or effects due to the inflammatory response.
Hope this helps to paint the picture of why air, even small volume, can have an effect similar to solid emboli.
I agree with Dr. Boldyrev: Dr. Bennett gave us a complete and outstanding lesson. Anyway, in my personal opinion, if a patient shows cerebral symptoms after CS we need to pray for 24 hours and after .....