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Updated: Jun 19, 2026

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

Published on: September 25, 2009

Hypodense middle cerebral artery with fat embolus.

Nicholas S Abend¹, Joshua M Levine

¹Division of Neurology, The Children's Hospital of Philadelphia, and Department of Neurology, Hospital of the University of Philadelphia, PA 19104, USA.

Neurocritical Care

|May 25, 2007

Summary

Fat embolism can cause stroke after aortic valve repair. A key CT scan finding is the "hypodense artery sign," indicating this rare complication.

Area of Science:

Neurology
Cardiovascular Surgery
Radiology

Background:

Fat embolism syndrome (FES) is a rare but serious complication following orthopedic procedures, trauma, and, less commonly, cardiac surgery.
Aortic valve repair, while beneficial, carries potential risks including thromboembolic events.

Observation:

A 44-year-old male patient presented with neurological deficits consistent with a stroke.
The stroke occurred in the territory of the right middle cerebral artery.
The patient had recently undergone an aortic valve repair procedure.

Findings:

Cerebral computed tomography (CT) revealed a large fat embolism as the cause of the stroke.
A characteristic finding on CT was the "hypodense artery sign," representing fat within the cerebral artery.

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This sign is a crucial radiographic indicator of cerebral fat embolism.

Implications:

The "hypodense artery sign" on CT is an important diagnostic clue for identifying cerebral fat embolism post-cardiac surgery.
Early recognition and management of fat embolism syndrome can potentially improve patient outcomes.
This case highlights the importance of considering fat embolism in patients with stroke following aortic valve repair.