A case of cerebral fat embolism after cardiac surgery
The present case has been reported in Neurology. A 61-year-old woman showed left hemiplegia and neglect while recovering 6 hours after aortic valve repair. CT revealed a hypodense middle cerebral artery segment. CT angiography and CT perfusion (CTP) revealed a carotid terminus occlusion and a large penumbra around a small ischemic core.

This prompted cerebral angiography, and embolectomy by Sofia catheter aspiration removed a 1.5-cm piece of adipose tissue, presumably pericardial fat introduced during aortotomy (figure). The neglect, hemianopia, and hemiparesis improved thereafter.

This demonstrates a successful fat embolus aspiration to treat stroke after cardiac surgery, and which should be considered if deficits are recognized early and CTP shows significant salvageable tissue.

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