Anand I Rughani1, Jeffrey E Florman, David B Seder. 1. Division of Neurosurgery, University of Vermont, 111 Colchester Ave, Fletcher 507, Burlington, VT 05401, USA. anand.rughani@mail.mcgill.ca
Abstract
BACKGROUND: Cerebral fat embolism is a well-described complication associated with long-bone fracture. However, with contemporary imaging, there is a distinct magnetic resonance imaging (MRI) pattern emerging. METHODS: The authors describe a case and briefly review the proposed etiology, clinical and radiographic diagnosis, treatment and outcome of cerebral fat embolism. RESULTS: A 21-year-old male sustained a femur fracture after a motor vehicle accident and had delayed pulmonary and neurological deterioration 2 days following injury. MRI of the brain demonstrated a pattern of diffuse punctuate hyperintense signal on T2-weighted and diffusion weighted imaging. This "starfield" pattern reversed on follow-up MRI at 1 month, and occurred in conjunction with remarkable clinical recovery. CONCLUSION: This case highlights the MRI findings associated with fat embolism, their reversibility, and offers insight into the significant clinical improvement that may occur in such patients.
BACKGROUND:Cerebral fat embolism is a well-described complication associated with long-bone fracture. However, with contemporary imaging, there is a distinct magnetic resonance imaging (MRI) pattern emerging. METHODS: The authors describe a case and briefly review the proposed etiology, clinical and radiographic diagnosis, treatment and outcome of cerebral fat embolism. RESULTS: A 21-year-old male sustained a femur fracture after a motor vehicle accident and had delayed pulmonary and neurological deterioration 2 days following injury. MRI of the brain demonstrated a pattern of diffuse punctuate hyperintense signal on T2-weighted and diffusion weighted imaging. This "starfield" pattern reversed on follow-up MRI at 1 month, and occurred in conjunction with remarkable clinical recovery. CONCLUSION: This case highlights the MRI findings associated with fat embolism, their reversibility, and offers insight into the significant clinical improvement that may occur in such patients.