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British Journal of Radiology (2010) 83, e18-e21
© 2010 British Institute of Radiology
doi: 10.1259/bjr/66268641
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Intracranial transthecal subarachnoid fat emboli and subarachnoid haemorrhage arising from a sacral fracture and dural tear

J K H Woo, MD D Malfair, MD T Vertinsky, MD M K S Heran, MD and D Graeb, MD

Division of Neuroradiology, University of British Columbia, Vancouver General Hospital, 855 West 12th Ave, Vancouver, BC V5Z 1M9, Canada

Correspondence: David Malfair, Division of Neuroradiology, University of British Columbia, Vancouver General Hospital, 855 West 12th Ave, Vancouver, BC V5Z 1M9, Canada. E-mail: dave.malfair{at}vch.ca

We present the case of a 28-year-old man with an unusual aetiology of lipid-dense material in the subarachnoid space. CT of the head at presentation was normal. MRI of the spine revealed a defect in the dura at L5/S1, with avulsed left L5 and S1 nerve roots. Haematoma and marrow fat were observed in close relation to the dural tear adjacent to the sacral fracture. Head CT and MRI subsequently demonstrated new lipid-dense material and haemorrhage in the subarachnoid space after sacral instrumentation, presumably owing to transthecal displacement of fatty marrow.






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