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Abstract Details

Akinetic Mutism Resulting from Cerebral Fat Embolism from Underlying Hemoglobin SC Disease Crisis
General Neurology
P1 - Poster Session 1 (9:00 AM-5:00 PM)
188

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Cerebral fat embolism is a syndrome primarily affecting the central nervous system. Akinetic mutism secondary to cerebral fat embolism due to underlying hemoglobin SC disease has not been previously documented in the literature.
A 70-year-old African American male with hemoglobin SC disease presented with 5 days of severe abdominal and whole-body pain. The patient was admitted and treated for a vaso-occlusive pain crisis. On his third day of hospitalization, he acutely developed an altered level of consciousness with impaired comprehension, mutism, and akinesia. Computed tomography (CT) angiography, magnetic resonance imaging (MRI), and gradient echo sequences (GRE) of the head were obtained which were unrevealing. The patient was then transferred to our tertiary care center where additional diagnostic evaluation was performed. Susceptibility-weighted imaging (SWI) showed a diffuse “walnut kernel” pattern and diffusion-weighted imaging (DWI) revealed a diffuse “starfield” pattern. Peripheral blood smear revealed evidence of active bone marrow necrosis. Together, these findings led to the diagnosis of cerebral fat embolism secondary to bone marrow infarction, which our patient was at increased risk of due to hemoglobin SC disease.
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Although SWI and DWI were contributory to our patient’s diagnosis, our patient had an unrevealing GRE. To our knowledge, this is the first reported case of akinetic mutism resulting from cerebral fat embolism due to underlying hemoglobin SC disease. Current data and research on microhemorrhage detection in cerebral fat embolism is based on SWI, but further evaluation of the utility of GRE as a diagnostic tool for cerebral fat embolism would contribute to the scientific literature.
Authors/Disclosures
Elsa C. Rodriguez, MD (University of Florida - Neurology)
PRESENTER 		Dr. Rodriguez has nothing to disclose.
William Remley, Jr., DO Dr. Remley has nothing to disclose.
Cyra Mae Bunag, PA (Baptist MD Anderson) Miss Bunag has nothing to disclose.
Varun Jain, MD, MBBS Dr. Jain has nothing to disclose.
Bhavana U. Patel, DO (Bhavana Patel) The institution of Dr. Patel has received research support from National Institute on Aging. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Question writer with 好色先生.