Background: Cerebral infarction is a rare complication of hyaluronic acid (HA) filler injection, usually presenting with sudden increase in intracranial pressure and loss of vision.
Methods: A 40-year-old Asian woman in a coma was transferred to the emergency intensive care unit of Xijing Hospital, China, 48 h after nasal augmentation with HA. Magnetic resonance imaging indicated cerebral infarction and left optic nerve edema and ischemia. Magnetic resonance angiography did not reveal vessel embolism.
Results: The patient developed gastric ulceration, pulmonary infection, respiratory failure, and cerebral herniation, and died 6 days after the HA filler injection.
Conclusion: Facial cosmetic HA filler injection can cause devastating and even fatal complications.
Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Keywords: Cerebral infarction; Embolism; Hyaluronic acid.