Role of susceptibility-weighted imaging in demonstration of cerebral fat embolism

Abstract

Cerebral fat embolism (CFE) is a rare but potentially lethal complication of long bone fractures. Many cases of CFE occur as subclinical events and remain undiagnosed. We report a case of a 22-year-old man, with multiple long bone fractures from a road traffic accident, who subsequently developed hypoxia, neurological abnormality and petechial rash. CT of the head was normal. MRI of the head confirmed the diagnosis with lesions markedly conspicuous and most widespread on susceptibility-weighted imaging as compared to all other sequences including diffusion-weighted imaging.

Cerebral fat emboli syndrome: do not miss the transcranial Doppler findings

“…Isolated cerebral fat emboli syndrome with subtle clinical signs not fulfilling Gurd's criteria and diagnosed by MRI and CT changes have been previously described 1. We describe middle cerebral artery Doppler findings (figure 1) in a case of cerebral fat embolism following isolated femoral bone open fracture in a 29-year-old woman who developed unexplained postoperative coma with normal brain CT findings.…”

Identification of reversible changes in cerebral fat embolism syndrome using susceptibility‐weighted imaging: A case report

“…Such SWI-DWI discrepancy is thought to be useful for CFE diagnosis. 5 In this case, the number of minute low-signal-intensity foci on SWI increased and then decreased over time. There are several possible explanations for this.…”

“…In our case, the amount and the spread of low‐signal‐intensities on SWI were more extensive than those of the DWI lesions. Such SWI‐DWI discrepancy is thought to be useful for CFE diagnosis 5 …”

Clinically compatible subject‐specific dynamic parallel transmit pulse design for homogeneous fat saturation and water‐excitation at 7T: Proof‐of‐concept for CEST MRI of the brain

“…Furthermore, in this study, the implemented fat suppression schemes were applied to healthy volunteers only. Their benefits might be more significant in pathologic cases with increased fat content, such as in intracranial lipomas 31,32 (mainly composed of adipose cells) or cerebral fat embolism 33 …”

“…Their benefits might be more significant in pathologic cases with increased fat content, such as in intracranial lipomas 31,32 (mainly composed of adipose cells) or cerebral fat embolism. 33 Finally, as the current objective is to achieve a fast whole-brain CEST protocol, the resolution was limited compared to slab-selective protocols, which can presently reach a resolution up to 1.8 × 1.8 mm 2 in-plane. 23 Partial volume effects, for example between WM and GM or between GM and cerebrospinal fluid, might therefore have partially mitigated the effects of lipid suppression.…”