Fatal Cerebral Infarction and Ophthalmic Artery Occlusion After Nasal Augmentation with Hyaluronic Acid—A Case Report and Review of Literature

Background Cerebral infarction is a rare complication of hyaluronic acid (HA) filler injection, usually presenting with sudden increase in intracranial pressure and loss of vision. Methods A 40-year-old Asian woman in a coma was transferred to the emergency intensive care unit of Xijing Hospital, China, 48 h after nasal augmentation with HA. Magnetic resonance imaging indicated cerebral infarction and left optic nerve edema and ischemia. Magnetic resonance angiography did not reveal vessel embolism. Results The patient developed gastric ulceration, pulmonary infection, respiratory failure, and cerebral herniation, and died 6 days after the HA filler injection. Conclusion Facial cosmetic HA filler injection can cause devastating and even fatal complications. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .