A case with Diffuse Axonal Injury associated with Cerebral Fat Embolism diagnosed by Susceptibility-Weighted Imaging

Abstract

Cerebral Fat Embolism (CFE) is known as potentially fatal complication of bone fracture. Patients with CFE develop variable and nonspecific clinical manifestations like a headache and disturbance of consciousness. Brain MRI has been reported to be the most sensitive method for diagnosing CFE, but conventional MR sequence is not sufficient for detecting CFE because some kind of pathological changes shows similar findings. We report a 74-year-old female with unstable pelvic fractures and diffuse axonal injury from traffic accident subsequently associated with cerebral fat embolism successfully diagnosed using susceptibility-weighted imaging (SWI). Brain MRI performed on day 6 revealed multiple high intensity lesions on diffusion-weighted imaging (DWI) in gray-white matter interface which may indicate cytotoxic edema due to DAI. We confirmed the diagnosis of CFE to find the presence of numerous petechial hemorrhages located predominantly in the white matter on SWI.