Mechanical thrombectomy for a cerebral fat embolism

Maïer, Benjamin; Badat, Neesmah; Boulouis, Grégoire; Zuber, Mathieu

doi:10.1007/s00134-019-05518-z

Cited by 5 publications

(9 citation statements)

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“…Eight of the reported patients had undergone cardiac surgery, most commonly mitral valve replacement (6 patients) (11,(14)(15)(16)(17)(18)(19)(20). Six patients had orthopaedic procedures or preceding trauma, and three patients were deemed spontaneous (2,10,(21)(22)(23)(24)(25)(26)(27). Of the spontaneous cases, one patient had a history of liposuction and gluteal augmentation 2 months prior, but this was presumed unrelated (2).…”

Section: Discussionmentioning

confidence: 99%

“…Distal contact aspiration alone (ADAPT) OR used in combination with stent retrievers would be a favoured first line approach. Of the 7 reported patients who underwent reperfusion therapy (ECR or STA-MCA bypass, excluding the patient who had unsuccessful ECR), 5 survived with reasonable function (modified Rankin scale 3 or better from case descriptions), one patient died due lack of clinical improvement, and another died due to intracranial haemorrhage shortly after ECR (2,14,(22)(23)(24)(25)(26). In comparison, of the patients who did not receive reperfusion therapy or received unsuccessful reperfusion therapy, five patients died, and two were functionally disabled (mRS 4) (10,15,17,18,21,27,28).…”

Section: Discussionmentioning

confidence: 99%

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Cerebral Large Vessel Occlusion Caused by Fat Embolism—A Case Series and Review of the Literature

et al. 2021

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The diagnosis of fat embolism syndrome typically involves neurological, respiratory and dermatological manifestations of microvascular occlusion 24–72 h after a precipitating event. However, fat embolism causing cerebral large vessel occlusion strokes and their sequelae have rarely been reported in the literature. This case series reports three patients with fat emboli post operatively causing cerebral large vessel occlusions, as well as a review of the literature to identify differences in clinical presentations and outcomes in stroke secondary to fat emboli causing large vessel occlusions compared to those with fat embolism syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cerebral Large Vessel Occlusion Caused by Fat Embolism—A Case Series and Review of the Literature

et al. 2021

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“…The utility of these drugs require further validation. Mechanical thrombectomy is also a possible treatment strategy for CFE [ 7 , 32 ]. Based on a recent case report, satisfying outcomes were demonstrated in a patient who underwent surgery [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Mechanical thrombectomy is also a possible treatment strategy for CFE [ 7 , 32 ]. Based on a recent case report, satisfying outcomes were demonstrated in a patient who underwent surgery [ 32 ]. Supportive therapy for CFE varies depending on the symptoms presented.…”

Section: Discussionmentioning

confidence: 99%

Delayed onset of fat embolus in the cerebral venous system after breast and hip augmentation: a case report

et al. 2021

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Background Cerebral fat embolism (CFE) is a subtype of fat embolism syndrome which tends to cause ischemic cerebral infarction. Fat embolism in the cerebral venous system have not been reported. We hereby present a rare case of fat embolus formed in the cerebral venous system 10 days after cosmetic surgery, and describe our management of this patient. Case presentation A 26-year-old woman with the disturbance of consciousness and recurrent convulsions of the right upper extremity over a 21-h period was admitted to our hospital. The patient was initially diagnosed with haemorrhagic infarction, and cerebral venous thrombosis (CVT) was suspected based on computed tomography (CT). A diagnosis of CFE was confirmed based on surgical findings. Breast and hip augmentation performed 10 days ago was considered the underlying cause. Drug-induced hypothermia, low molecular weight heparin, atorvastatin, dexamethasone, piperacillin/tazobactam, valproic acid, and mannitol were applied. On hospital day 30, she was discharged with a Montreal Cognitive Assessment score of 25. Conclusions Fat embolism can occur in the cerebral venous system, and may mimic CVT symptoms rather than CFE symptoms. Early identification of the nature of the embolus is essential. The use of heparin may prevent secondary thrombus formation, and accelerate fat embolus decomposition.

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“…Whilst the treatment of cerebral fat embolism is largely supportive, there have been two case reports published recently which described successful mechanical fat embolectomy 3,4 . Noting the possibility of successful mechanical embolectomy in cases of large intra‐cranial vessel occlusion secondary to macroscopic fat embolism, this differential diagnosis should be considered in patients with post‐operative drowsiness particularly following a hip hemiarthroplasty even if other classical clinical manifestations of fat embolism syndrome are absent.…”

Section: Discussionmentioning

confidence: 99%

Hypodense MCA sign – Large‐vessel occlusion secondary to fat embolism post‐right hip hemiarthroplasty

et al. 2020

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Mechanical thrombectomy for a cerebral fat embolism

Cited by 5 publications

References 0 publications

Cerebral Large Vessel Occlusion Caused by Fat Embolism—A Case Series and Review of the Literature

Cerebral Large Vessel Occlusion Caused by Fat Embolism—A Case Series and Review of the Literature

Delayed onset of fat embolus in the cerebral venous system after breast and hip augmentation: a case report

Hypodense MCA sign – Large‐vessel occlusion secondary to fat embolism post‐right hip hemiarthroplasty

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