CASE REPORT Cement-Embolic Stroke Associated with

SUMMARY: Major neurologic morbidity and mortality with vertebroplasty are rare. We describe a 71-year-old woman who had a stroke approximately 30 minutes after vertebroplasty. Imaging revealed that bone cement had embolized to the left middle cerebral artery. Emergency embolectomy was attempted but was unsuccessful. This report emphasizes the need to be aware that intracranial embolization of polymethylmethacrylate can occur and describes management strategies to consider. Vertebroplasty is considered a very safe and effective proce-dure to treat painful compression fractures, with nearly 90 % of patients experiencing some pain relief.1 Symptomatic complications are uncommon, reported to occur in the range of 1%–3 % for osteoporotic compression fractures and slightly more for neoplastic ones. The most feared complications are related to extravertebral extrusion of cement. This has been described in approximately 41 % of patients; fortunately, it rarely leads to symptoms.1 A small amount of polymethyl-methacrylate (PMMA) leakage into the paravertebral soft tis-sues or intervertebral disk space is generally of no clinical sig