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Background To analyze the clinical features of brain tumor-related epilepsy (BTRE) and explore the factors influencing the identification of epilepsy-associated tumor (EAT), in order to advance the clinical understanding of BTRE and EAT. Methods Intracranial tumor origin and location as well as the type of epilepsy were retrospectively reviewed in 153 BTRE patients. The patients were further divided into the EAT and non-EAT groups, and comparisons were made for age, sex, tumor origin and location, and epilepsy type between the two groups. Results The 153 BTRE patients were divided into 78 cases with primary intracranial tumor and 75 cases with tumor originating from extracranial metastasis, according to the origin of tumor. According to the location of tumor, 116 cases had tumor lesions located in the brain parenchyma, and 37 cases had tumor lesions located in the meninges. Further, in the group with a brain parenchyma location, 77 cases had single lobular involvement, and 39 cases had multiple-lobular involvement; 84 cases had tumor lesions located in one hemisphere and 32 cases in both hemispheres. According to the type of epilepsy, 92 cases had generalized seizures, and 61 cases had focal seizures. The type of epilepsy did not significantly correlate with the origin of intracranial tumor, the location of tumor lesions (in brain parenchyma or meninges) (P > 0.05), or the hemispherical location (in one or two hemispheres) of lesions (P > 0.05), but was significantly related with the lobular localization of lesions (P < 0.05). The 153 cases of BTRE consisted of 87 EAT and 66 non-EAT, with significant differences in the origin, location and type (being glioma/non-glioma) of tumor. Logistic regression analysis showed that the type of tumor (i.e. whether being glioma) served as an independent factor for EAT identification; the lower the World Health Organization grade of glioma, the more likely the EAT is to be diagnosed (P < 0.05). Conclusion The majority of BTRE patients in this study had tumors located in the brain parenchyma. In addition, the patients with generalized seizures outnumbered those with focal seizures, and the type of epilepsy was correlated with the lobular location of tumor lesions. The EATs are mostly low-grade gliomas.

Rationale: 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. Patient concerns: 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. Diagnosis: 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. Interventions: The patient received anticoagulation and lipid-lowering therapy. Outcomes: 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. Lession: This case report shows the characteristics of CFE on SWI, which can help clinicians in diagnosing which can help clinicians in diagnosing CFE.