18 years old male with multiple bone fractures including head trauma
Examination demonstrates multiple punctate form diffusion signal abnormality lesions in bilateral cerebellar hemispheres, left worse than right bilateral cerebellar peduncles, midbrain, upper vermis as well as bilateral thalami, basal ganglia and hemispheric subcortical and cortical distributions in keeping with multiple embolic lesions. Susceptibility weighted images demonstrate punctate form scattered too numerous to count susceptibility signal loss lesions without blooming effects matching the distribution of the diffusion signal abnormality lesions. FLAIR and T2-weighted images demonstrate hyperintense behavior in the same distributions. T1-weighted images demonstrate few of the lesions demonstrating hyperintense behavior. Imaging findings of concern for diffuse fat embolism, which may correlate with tubular bone fractures with associated bone marrow fat embolism.