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27 October 2008

Encephalopathy and MRI abnormalities in fat embolism syndrome: a case report

Christianne J. BuskensBEF, Jan Willem C. GratamaCD, Mike HogervorstB, Roeland B. van LeeuwenD, Johannes H. RommesAF, Peter E. SpronkACE

Med Sci Monit 2008; 14(11): CS125-129 :: ID: 869428

Abstract

Background
Fat embolization and fat embolism syndrome are poorly understood complications of skeletal trauma. Fat embolism syndrome is a clinical diagnosis, and patients typically present with a classic triad of petechial rash, pulmonary distress, and neurologic dysfunction. The incomplete form of the syndrome (i.e., cerebral fat embolism) is a more challenging clinical diagnosis in which brain magnetic resonance imaging may be a valuable tool. Fat embolism syndrome can be a life-threatening condition, but the latent form that occurs 24 to 72 hours after the trauma is frequently described as a self-limiting condition.
Material and Method
In this report, we present the case of a 32-year-old man with fat embolism syndrome and a prolonged coma with persistent cerebral dysfunction. Brain magnetic resonance imaging revealed multiple white and grey matter lesions suggestive of vasogenic edema and punctuate hemorrhage, consistent with a diagnosis of cerebral fat emboli.
Results

Conclusions
The pathogenesis and treatment options of fat embolism syndrome are reviewed based on available literature, and the usefulness of brain magnetic resonance imaging is discussed.

Keywords: Magnetic Resonance Imaging, Embolism, Fat - pathology, Syndrome, Brain Damage, Chronic - pathology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750