Fat emboli responsible for ischemic stroke in reconstructive eye surgery
Fat emboli responsible for ischemic stroke in reconstructive eye surgery
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DOI：
10.1007/s00415-010-5621-5
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发表时间：
2010-06
影响因子：
6
通讯作者：
Sarah Tolédano;Julie Zyss;S. Gerber;M. Rodallec;M. Zuber
中科院分区：
文献类型：
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作者：
Sarah Tolédano;Julie Zyss;S. Gerber;M. Rodallec;M. Zuber
一位33岁的女性在接受眼部重建手术时接受了左侧眼眶内的自体脂肪注射，之后接受了感染的假眼置换手术。过去的病史是平淡无奇的，除了从6岁开始的眼球缺乏症，在过去的十年里做了几次手术。在取出感染的假体后，进行了部分眼眶重建。8个1毫升的注射器，每个包含1毫升的自体脂肪，其中2个注射到Margo眼眶区域，另外6个注射到眼眶。术中及术后均未出现心律失常或血压下降。醒来后，患者出现完全性右侧偏瘫。脑部MRI显示左侧大脑中动脉(MCA)区域有一大块脑梗塞(图1)。颈部和经颅超声、经胸和经食道超声心动图、24小时动态心电图和生物学检查均正常。除脑缺血外，MRI还显示左侧海绵窦和左侧大脑中动脉远端分支均存在T1高信号异常。这些异常在脂肪饱和的序列中消失，证实了它们
A 33-year-old woman underwent autologous fat injection in the left orbit during reconstructive eye surgery before replacement of an infected eye prosthesis. Past medical history was uneventful except for anophthalmia since age 6, responsible for several operations over the past decade. After removal of the infected prosthesis, a partial reconstruction of the orbit was performed. Eight 1-mL syringes, each containing 1 mL of autologous fat were injected, two into the margo orbitalis region, and the six others into the orbital cavity. No cardiac arrhythmia or drop of blood pressure was recorded during surgery or the postoperative period. Upon awakening, the patient presented a complete right hemiplegia.Brain MRI revealed a large cerebral infarction in the left middle cerebral artery (MCA) territory (Fig. 1). Cervical and transcranial ultrasonography, transthoracic and transoesophageal echocardiography, 24 h-Holter ECG and the biological workup were all normal. In addition to cerebral ischemia, MRI showed the presence of T1-hyperintensive abnormalities, both in the left cavernous sinus and in several distal branches of the left MCA. These abnormalities disappeared on sequences with fat saturation, confirming their