Cerebrovascular infarction after cosmetic facial injections: a case report and literature review

Abstract

Objective To report a case who had cerebral hemorrhage after facial injection with hyaluronic acid and to present the literature review about cerebrovascular infarction after cosmetic facial injection. Methods Articles were collected from domestic and overseas database, with the key word of filler injection, autologous fat, hyaluronic acid, stroke, cerebrovascular disease, cerebral embolism from 1990 January to 2016 July. Information about researchers, patients, injection, complication, therapy and prognosis was collected. Results The analysis shows cases are mostly reported by South Korea among the 18 articles in total (20 cases). 81% of injection material is autologous fat and the rest is hyaluronic acid.Glabella is mostly injected(n=9). Symptoms of cerebrovascular infarction are paralysis(n=15), disturbance of consciousness(n=7) and aphasia(n=5), whose onset were mostly within the operation(47%, n=8). 81% cases were combined with blindness. Infarction positions mostly were middle cerebral artery(n=14), anterior cerebral artery(n=6), frontal lobe(n=6)and parietal lobe(n=5). Meanwhile, there were three cases combined with cerebral hemorrhage including the case we reported in this article. Blind patients had poor prognosis while the other neurologic symptoms mostly could be improved. Conclusions Cerebrovascular infarction is a rarely severe complication of cosmetic facial injection, which we should pay close attention to. Key words: Cosmetic facial injection; Autologous fat; Cerebrovascular accident