From the Research
A shifting fat globule in the lateral ventricle can cause several serious complications, most notably intermittent or positional obstructive hydrocephalus, which can lead to increased intracranial pressure and potentially life-threatening symptoms. The potential complications of a shifting fat globule in the lateral ventricle include:
- Intermittent or positional obstructive hydrocephalus, which occurs when the mobile fat globule blocks the flow of cerebrospinal fluid (CSF), leading to increased intracranial pressure 1
- Chemical meningitis or ventriculitis due to the irritating effect of fat on the ventricular lining
- Seizures triggered by the mechanical irritation of surrounding brain tissue
- Ischemic damage to periventricular structures if blood vessels are compressed
- Inflammation of the ependymal lining of the ventricles, potentially leading to scarring and permanent CSF flow obstruction
These fat globules typically originate from dermoid cysts, cranial trauma with skull fracture, or as complications of neurosurgical procedures 1. Management usually requires neurosurgical intervention to remove the fat globule, especially if causing symptomatic obstruction, along with close neurological monitoring and sometimes CSF diversion procedures like ventriculostomy or shunt placement for hydrocephalus. The most recent study on intracranial fat pathology highlights the importance of radiologic evaluation in diagnosing and managing such conditions 1.
The pathophysiology of hydrocephalus and increased intracranial pressure is complex and involves the imbalance of CSF production and absorption, as well as obstruction of CSF pathways 2, 3. The diagnosis and differential diagnosis of hydrocephalus in adults involve imaging techniques such as MRI and CT scans, which play a crucial role in identifying the underlying cause of the condition 4. In pediatric populations, the radiologic evaluation of hydrocephalus is also critical, and MRI sequences such as 3D CISS, cine PC, TSE, and GRE T2* sequences can be used to investigate obstructive pathology through the CSF pathway and assess the efficiency of treatment 5.
However, the most recent and highest quality study on the topic of intracranial fat pathology 1 suggests that the presence of intracranial adipose tissue can be detected in different physiological and pathological conditions, and that radiologists and neuroradiologists should be aware of the various scenarios in which intracranial fat may be encountered. Therefore, based on the most recent evidence, it is recommended that patients with a shifting fat globule in the lateral ventricle undergo prompt neurosurgical evaluation and management to prevent potentially life-threatening complications.