Fat emboli and critical illness-associated cerebral microbleeds (CICMs) in a patient with sickle cell disease: Do these 2 entities coexist?

Abstract

We report the case of a 30-year-old female patient with sickle cell disease presenting with an acute chest syndrome and neurological deterioration. Cerebral magnetic resonance imaging revealed a handful of foci of diffusion restriction and numerous microbleeds with marked involvement of corpus callosum and subcortical white matter, with relative sparing of the cortex and deep white matter. Corpus callosum-predominant and juxtacortical microbleeds have been typically documented in cerebral fat embolism syndrome, but also in the so-called “critical-illness-associated cerebral microbleeds”, a recently described entity associated with respiratory failure. We discussed whether these 2 entities may coexist.

Keywords

• Sickle cell disease
• MRI
• Cerebral microbleed
• Cerebral fat embolism
• Starfield pattern