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[Neurologic manifestations of fat embolism]
A Bouaggad1, A Harti, M Elmouknia
1Service d'Anesthésie-Réanimation, CHU Ibn Rochd, Casablanca, Maroc.
Cahiers D'Anesthesiologie
|January 1, 1995
Summary
Post-traumatic fat embolism frequently causes varied neurologic symptoms, including impaired consciousness. Most patients recover fully within weeks, showing the generally good prognosis for neurologic recovery.
Area of Science:
- Neurology
- Trauma Surgery
- Intensive Care Medicine
Background:
- Fat embolism syndrome (FES) is a serious complication following trauma.
- Neurologic manifestations are common but their pathogenesis remains debated.
- Early recognition and management are crucial for patient outcomes.
Purpose of the Study:
- To describe the clinical presentation and CT findings in patients with post-traumatic fat embolism and neurologic signs.
- To evaluate the outcomes and prognosis of neurologic involvement in FES.
Main Methods:
- Retrospective case series of 13 patients treated in a surgical intensive care unit.
- Inclusion criteria: post-traumatic fat embolism with documented neurologic signs.
- Data collected included clinical presentation, brain CT findings, and patient outcomes.
Main Results:
- All 13 patients presented with impaired consciousness.
- Focal neurologic deficits occurred in 5 patients (hemiplegia, tetraplegia, aphasia).
- Brain CT scans were normal in 10 patients, showed ischemic lesions in 1, and hemorrhagic lesions in 2.
- 11 out of 13 patients had a good outcome with complete neurologic recovery within 2-4 weeks.
- Two deaths occurred, one due to severe brain trauma and another to nosocomial pneumonia.
Conclusions:
- Post-traumatic fat embolism commonly presents with altered consciousness and variable focal neurologic deficits.
- Brain CT findings in FES are often non-specific or absent.
- Despite initial neurologic impairment, prognosis for neurologic recovery is generally favorable in survivors.