• David B Seder, Anand I Rughani, and Jeffrey E Florman.
• Division of Neurosurgery, University of Vermont, 111 Colchester Ave, Fletcher 507, Burlington, VT 05401, USA. anand.rughani@mail.mcgill.ca
• Neurocrit Care. 2011 Aug 1;15(1):190-3.

BackgroundCerebral fat embolism is a well-described complication associated with long-bone fracture. However, with contemporary imaging, there is a distinct magnetic resonance imaging (MRI) pattern emerging.MethodsThe authors describe a case and briefly review the proposed etiology, clinical and radiographic diagnosis, treatment and outcome of cerebral fat embolism.ResultsA 21-year-old male sustained a femur fracture after a motor vehicle accident and had delayed pulmonary and neurological deterioration 2 days following injury. MRI of the brain demonstrated a pattern of diffuse punctuate hyperintense signal on T2-weighted and diffusion weighted imaging. This "starfield" pattern reversed on follow-up MRI at 1 month, and occurred in conjunction with remarkable clinical recovery.ConclusionThis case highlights the MRI findings associated with fat embolism, their reversibility, and offers insight into the significant clinical improvement that may occur in such patients.

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