Abstract 079: Cerebral Fat Embolism with “Starfield Pattern on MRI Brain” Secondary to Sickle Cell Beta Thalassemia

Cerebral Fat embolism (CFE) is typically discussed as a manifestation of a traumatic fracture of a long bone. However, a rare consequence of Sickle cell disease (SCD) is bone marrow necrosis from a vaso‐occlusive crisis causing fat embolisms. These fat embolisms can enter the brain vasculature via two mechanisms. Fat microglobules can filter through the lung capillaries and/or enter the left atrium in the setting of a shunt, such as a Patent Foramen Ovale (PFO). Brain MRI in CFE shows a specific pattern known as a “starfield pattern”, named for the multifocal punctate infarcts and microhemorrhages seen on imaging. MRI imaging of bones would demonstrate heterogeneous hyperintensities consistent with avascular necrosis in the setting of a starfield pattern on MRI brain, confirming the diagnosis. We present a case of a patient with sickle cell beta thalassemia with CFE. Our case report highlights an underreported phenomenon to aid in the prompt diagnosis of similar cases in the future.