Cerebral Fat Embolism as Complication of Facial Fat Graft: Retrospective Analysis of Clinical Characteristics, Treatment, and Prognosis

World Neurosurg. 2018 Dec:120:249-255. doi: 10.1016/j.wneu.2018.08.148. Epub 2018 Aug 27.

Abstract

Background: Cerebral fat embolism (CFE) is a rare complication that usually occurs after trauma injury. The incidence of CFE due to aesthetic surgery is extremely rare and can lead to fatal outcome. Due to the rarity of this complication, there is still lack of knowledge and standardization of the treatment.

Case description: Herein, we reported 6 cases of CFE that occurred in patients who underwent cosmetic surgery. Among 5 patients who had large artery occlusion, 3 patients survived and 2 patients died due to progression of the disease. One patient had the ophthalmic artery occlusion. In addition, embolectomy was performed in 5 patients and 3 patients had decompressive craniectomy following endovascular treatment due to severe brain edema.

Conclusions: CFE is associated with high morbidity and mortality, and early surgical intervention can improve the prognosis.

Keywords: Cerebral; Fat embolism; Prognosis; Treatment.

MeSH terms

  • Adipose Tissue / transplantation*
  • Adult
  • Angiography, Digital Subtraction
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / surgery
  • Brain Edema / diagnostic imaging
  • Brain Edema / etiology
  • Brain Edema / surgery
  • Cerebral Arterial Diseases / diagnostic imaging
  • Cerebral Arterial Diseases / etiology
  • Cerebral Arterial Diseases / surgery
  • Combined Modality Therapy
  • Cosmetic Techniques / adverse effects*
  • Decompressive Craniectomy
  • Disease Progression
  • Embolectomy
  • Embolism, Fat / diagnosis
  • Embolism, Fat / etiology*
  • Embolism, Fat / surgery*
  • Female
  • Humans
  • Intracranial Embolism / etiology*
  • Intracranial Embolism / surgery*
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery
  • Prognosis
  • Retrospective Studies
  • Young Adult