Department of Neurology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Medicine (Baltimore). 2022 Aug 12;101(32):e29462. doi: 10.1097/MD.0000000000029462.
Cerebral fat embolism (CFE) is a rare but critical disease in a clinical setting. Considering that manifestations and CT findings of CFE tend to be atypical, this condition is very difficult to diagnose. The purpose of this article was to assess the value of susceptibility-weighted imaging (SWI) in the diagnosis of CFE.
Our patient was an 80-year-old woman who developed hypoxemia, quadriplegia, and progressive confusion after fracture of the right femoral neck and right superior ramus of pubis within 24 hours.
T2-weighted magnetic resonance imaging (T2 W MRI), fluid-attenuated inversion recovery sequences, and diffusion-weighted imaging showed numerous hyperintense foci in the subcortex and white matter of both cerebral hemispheres, some of which were confluent and SWI showed multiple symmetrical punctate microhemorrhages in both hemispheres. Base on the history and MRI findings, the patient was diagnosed with CFE.
The patient received anticoagulation and lipid-lowering therapy.
The patient regained consciousness, and her muscle strength in the limbs gradually recovered. One year after discharge, the patient could independently walk on her own.
This case report shows the characteristics of CFE on SWI, which can help clinicians in diagnosing which can help clinicians in diagnosing CFE.
脑脂肪栓塞(CFE)是临床罕见但危急的疾病。鉴于 CFE 的临床表现和 CT 表现往往不典型,因此该疾病的诊断极具难度。本文旨在评估磁共振磁敏感加权成像(SWI)在 CFE 诊断中的价值。
患者为 80 岁女性,在右侧股骨颈骨折和右侧耻骨上支骨折后 24 小时内出现低氧血症、四肢瘫痪和进行性意识模糊。
T2 加权磁共振成像(T2 W MRI)、液体衰减反转恢复序列和弥散加权成像显示双侧大脑皮质和白质有许多高信号病灶,有些病灶融合,SWI 显示双侧半球有多个对称的点状微出血。根据病史和 MRI 结果,患者被诊断为 CFE。
患者接受抗凝和降脂治疗。
患者意识恢复,四肢肌力逐渐恢复。出院 1 年后,患者可独立行走。
本病例报告显示了 CFE 在 SWI 上的特征,有助于临床医生诊断 CFE。