Hemorrhagic Stroke and Blindness after Hyaluronic Acid/Polylactic Acid Filler Injection

Abstract

The number of people receiving facial filler injections is increasing as it is relatively safe than the other cosmetic procedures. However, complications of facial filler injection range from mild redness and inflammation to cerebral infarction. We report the case of a patient who was diagnosed with cerebral infarction and intracranial hemorrhage after facial filler injection. A 61-year-old male presented to the emergency department with ocular pain and visual loss in the left eye after filler injection into the glabella. Neurological examination revealed monocular blindness. Initial brain magnetic resonance imaging (MRI) revealed small, acute multifocal infarctions in the left frontal, parietal, and temporal lobes. Follow-up MRI revealed subarachnoid hemorrhages in the left frontal and parietal lobe. Follow-up brain computed tomography showed small intracerebral hemorrhage in the left frontal lobe. Clinicians must be aware that not only cerebral infarction, but intracranial hemorrhage could also be a potential adverse effect of the cosmetic filler injection in the face.