Cerebral fat embolism detection with susceptibility-weighted images in sickle cell disease

Cerebral fat embolism is a known but feared complication of sickle cell disease, which leads to significant morbidity. Although trauma-related fat embolism is more frequent and its diagnosis is straightforward, fat embolism secondary to bone infarcts after vaso-occlusive events can be unrecognized. Lack of criteria make the clinical diagnosis of sickle cell disease related fat embolism challenging. The neuroimaging findings are helpful to support the clinical diagnosis. Magnetic resonance imaging findings of fat embolism have been described including those seen on susceptibility-weighted imaging. Even though susceptibility-weighted imaging has been used for the diagnosis of cerebral fat embolism due to trauma, to the best of our knowledge its use has not been described in patients with sickle cell disease. We report an uncommon case of a 60-year-old woman with sickle cell disease who developed cerebral fat embolism and in which the findings on susceptibility-weighted imaging were characteristic and established the diagnosis.