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Updated: Jun 17, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
[Coma after lucid interval--severe secondary alteration of consciousness following multiple trauma]
J C Richter1, M M Stansiak, P Freitag
1Medizinische Klinik, Regionalspital Emmental, Burgdorf. j.c.richter_md@hotmail.com
Abstract:
A 71-year-old man sustains multiple fractures in an accident; after a lucid interval he deteriorates neurologically and becomes comatose. Intracranial hemorrhage, status epilepticus, adverse drug reactions, toxic-metabolic, ischemic or infectious causes are subsequently ruled out. Development of petechiae and thrombopenia raises the possibility of fat embolism syndrome, which is confirmed in a MRI of the head 72 hours after the accident. We discuss current aetiologic concepts as well as diagnosis and clinical course of the cerebral fat embolism syndrome.
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