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Reversible Cytotoxic Cerebral Edema in Cerebral Fat Embolism

D.J.A. Butterissa, D. Mahadb, C. Soha, T. Wallsb, D. Weirc and D. Birchalla

a Department of Neuroradiology, Newcastle General Hospital, Newcastle-upon-Tyne, Tyne and Wear, United Kingdom
b Department of Neurology, Newcastle General Hospital, Newcastle-upon-Tyne, Tyne and Wear, United Kingdom
c Department of Orthopaedic Surgery, Newcastle General Hospital, Newcastle-upon-Tyne, Tyne and Wear, United Kingdom


Figure 1
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  		Fig 1. A–C, Axial T2-weighted images 7 days after the ictus, demonstrating punctate hyperintensities throughout the white matter, on a background of slightly increased white matter signal intensity consistent with edema.


Figure 2
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  		Fig 2. A–C, Axial diffusion-weighted images (DWI) at corresponding sections. Marked signal intensity hyperintensity throughout the white matter demonstrates reduced diffusivity consistent with cytotoxic edema. Punctate areas of greater signal intensity correspond to the lesions shown on T2-weighted images.


Figure 3
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  		Fig 3. A–C, Axial apparent diffusion coefficient (ADC) maps at corresponding sections, demonstrating reduced diffusivity as low signal intensity throughout the cerebral white matter.


Figure 4
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  		Fig 4. Axial T2-weighted (A–C) and diffusion-weighted images (DWI) (D–F), and apparent diffusion coefficient (ADC) maps (G–I) at corresponding sections 30 days after the ictus. Scattered punctate hyperintensities consistent with lacunar infarcts are present in areas that correlate with focal areas of signal intensity abnormality in the previous figures. The generalized mild T2 hyperintensity and reduced DWI and ADC map diffusivity have resolved.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X