日本神経救急学会雑誌
Online ISSN : 2187-5006
Print ISSN : 1619-3067
ISSN-L : 1619-3067
症例報告
びまん性軸索損傷に合併した脳脂肪塞栓症の診断にSWIが有用であった1例
鶴田 啓亮關 匡彦井上 剛至田 洋一淺井 英樹倉 知彦中野 健一川井 廉之前川 尚宜福島 英賢奥地 一夫
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2016 年 28 巻 3 号 p. 35-39

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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.

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