In this study, we analyzed two cases of pure cerebral fat embolism and reviewed related literatures to explore the pathogenesis, clinical manifestations, diagnosis and treatment of cerebral fat embolism, improve the treatment efficiency and reduce the misdiagnosis rate. In our cases, patients fully returned to consciousness at the different times with good prognosis, normal vital signs and without obvious sequelae. For patients with the limb fractures, who developed coma without chest distress, dyspnea or other pulmonary symptoms 12 or 24 h post injury, cerebral fat embolism should be highly suspected, except for those with intracranial lesions, such as delayed traumatic intracerebral hemorrhage, etc. The early diagnosis and comprehensive treatment can improve prognosis.
Adult ; Embolism, Fat ; diagnosis ; etiology ; therapy ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male

A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.
Adult ; Aged ; Biopsy, Needle/*adverse effects/methods ; Embolism, Air/*etiology/therapy ; Female ; Humans ; Hyperbaric Oxygenation ; Intracranial Embolism/*etiology/therapy ; Lung/*pathology ; Male ; Radiography, Interventional

Brain Infarction ; diagnosis ; etiology ; therapy ; Cerebral Angiography ; Child ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Neoplasms ; complications ; diagnosis ; surgery ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male ; Myxoma ; complications ; diagnosis ; surgery ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Thrombosis ; diagnosis ; etiology ; therapy

Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for unresectable hepatocellular carcinoma (HCC). Although various complications of TACE have been reported, cerebral lipiodol embolism after TACE is rare. We report a 67-year-old man, who had patent foramen ovale and developed cerebral lipiodol embolism after TACE via the inferior phrenic artery. At 20 months after third TACE of 3 cm sized HCC in the left hepatic lobe, computed tomography (CT) revealed about 1.6 cm newly developed HCC in the anterior superior segment of right hepatic lobe. The angiogram revealed the HCC was supplied from the right inferior phrenic artery. Toward the end of TACE, there were accumulations of the iodized oil in the pulmonary vasculature. Immediately after TACE, he complained of weakness in right upper and lower limbs and sensory decrease in right limbs and right hemitrunk. Magnetic resonance imaging revealed a cerebral lipiodol embolism. Transesophageal echocardiography revealed no visible thrombi but contrast-echocardiography using hand agitated saline revealed an intracardiac right to left shunt consistent with patent foramen ovale. Motor weakness and sensory decrease were gradually improved, and all neurological symptoms disappeared over 4 weeks.
Aged ; Carcinoma, Hepatocellular/complications/diagnosis/*therapy ; *Chemoembolization, Therapeutic ; Contrast Media/*adverse effects/diagnostic use ; Humans ; Intracranial Embolism/*diagnosis/*etiology/ultrasonography ; Iodized Oil/*adverse effects/diagnostic use ; Liver Neoplasms/complications/diagnosis/*therapy ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

OBJECTIVETo report the initial application of brain protection device in the dilatation and stenting of atherosclerotic stenosis of the carotid and vertebral artery.

METHODSEighteen patients with 21 atherosclerotic stenoses of the carotid or vertebral artery underwent dilatation and/or stenting with brain protection device (filterwire or angioguard). The clinical results were summarized and the indispensability and feasibility of the device was discussed.

RESULTSWith the aid of brain protection device, endovascular dilatation and (or) stenting were performed in all the patients with 21 stenoses of the carotid or vertebral artery. The interventional manipulation was successful and no complications occurred.

CONCLUSIONSBrain protection device is helpful to decrease the embolic complication caused by atherosclerotic plaque and thromboembolus and to increase the security of interventional therapy, during the dilatation and/or stenting of stenosis of the carotid or vertebral artery.

Adult ; Aged ; Angioplasty, Balloon ; adverse effects ; methods ; Carotid Stenosis ; therapy ; Female ; Follow-Up Studies ; Humans ; Intracranial Embolism ; etiology ; prevention & control ; Male ; Middle Aged ; Protective Devices ; Stents ; adverse effects ; Vertebrobasilar Insufficiency ; therapy

There has been a controversy over data of thrombolytic and endovascular surgical treatment about cerebral infarction secondary to infective endocarditis. We report a woman who received early mechanical embolectomy as a treatment of acute stroke with infective endocarditis. A 35-yr-old woman was hospitalized due to right hemiparesis. Brain image showed cerebral infarction at the middle cerebral artery and echocardiography demonstrated vegetation at the mitral valve. She was successfully treated with embolectomy and parenteral antibiotics without any neurologic sequelae. This report shows that the early retrieve of septic cerebral emboli can be a helpful treatment of acute stroke associated with endocarditis.
Adult ; Anti-Bacterial Agents/therapeutic use ; Cerebral Arteries/radiography/*surgery ; Embolectomy ; Endocarditis/complications/*diagnosis/drug therapy ; Female ; Humans ; Intracranial Embolism/surgery ; Mitral Valve/ultrasonography ; Streptococcus/isolation & purification ; Stroke/*diagnosis/etiology/surgery ; Tomography, X-Ray Computed