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Extremely Acute-Onset Cerebral Fat Embolism.
1Department of Intensive Care Medicine, Aso Iizuka Hospital, Fukuoka 820-8505, Japan.
International Journal of General Medicine
|October 29, 2020
Summary
Cerebral fat embolism (CFE) can rapidly cause coma after long bone fractures, often within an hour. This case highlights the need to consider CFE in sudden post-trauma consciousness loss.
Area of Science:
- Neurology
- Trauma Medicine
- Radiology
Background:
- Fat embolism syndrome (FES) is a post-traumatic complication typically following long bone fractures.
- Neurological involvement in FES, known as cerebral fat embolism (CFE), usually manifests 24-72 hours post-injury.
Observation:
- An elderly female with a femur fracture experienced sudden coma 55 minutes post-trauma.
- Initial CT scans were normal; MRI revealed a characteristic "starfield" pattern of hyperintense lesions on diffusion-weighted imaging.
- Petechiae were observed, and the patient remained comatose for 4 months.
Findings:
- The patient was diagnosed with CFE, presenting unusually rapidly after trauma.
- The rapid onset of CFE, less than an hour after injury, challenges the typical presentation timeline.
Implications:
- CFE should be suspected in cases of sudden consciousness deterioration shortly after long bone fractures.
- Early consideration of CFE is crucial for timely diagnosis and management in trauma patients.
- This case underscores the potential for rapid neurological decline in CFE.
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