Cerebral fat embolism

Case contributed by Dr Kauv Paul

Presentation

Sickle cell patient. History of bone infarct.

Patient Data

Age: 30 years
Gender: Female
MRI

Diffuse, tiny foci of susceptibility artifacts showing no predilection. No restricted diffusion. 

Case Discussion

Innumerable small regions of susceptibility artifact (more than 100) lead to the diagnosis of cerebral fat embolism. With a history of bone infarct, it is likely the etiology of embolism rather than the more common bone fracture. This patient had sickle cell disease, which could lead to the bone infarct and subsequent cerebral fat embolism.

The embolic lesions are visible in T2*, but better depicted on SWI.

Differentials are amyloid angiopathy or chronic hypertensive encephalopathy, but in those diseases, the hemorrhagic lesions are usually bigger and fewer and do not show such a striking global distribution in the brain. 

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