• Xianwen Zhang, Liaoyuan Zheng, Jinfeng Duan, Shunyuan Zhang, Ying Zhou, and Yufeng Tang.
• Department of Neurology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
• Medicine (Baltimore). 2022 Aug 12; 101 (32): e29462e29462.

RationaleCerebral 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 ConcernsOur 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.DiagnosisT2-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.InterventionsThe patient received anticoagulation and lipid-lowering therapy.OutcomesThe patient regained consciousness, and her muscle strength in the limbs gradually recovered. One year after discharge, the patient could independently walk on her own.LessionThis case report shows the characteristics of CFE on SWI, which can help clinicians in diagnosing which can help clinicians in diagnosing CFE.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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