Journal of Trauma and Injury

Case Reports

Cerebral Fat Embolism That Was Initially Negative on DiffusionWeighted Magnetic Resonance Imaging: Seung Je Go, Yun Su Mun, Seung Ho Bang, Yong Han Cha, Young Hoon Sul, Jin Bong Ye, Jae Guk Kim; J Trauma Inj. 2021;34(2):126-129. Published online March 22, 2021; DOI: https://doi.org/10.20408/jti.2020.0007

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Abstract PDF: Fat embolism syndrome is a rare, but serious condition that occurs in patients with fractures of the long bones or who undergo orthopedic surgery. The main clinical features of fat embolism syndrome are an altered mental status, hypoxia, and petechial rash. Cerebral fat embolism is the most severe manifestation of fat embolism syndrome because it can lead to an altered mental status. The diagnosis of cerebral fat embolism is clinical, but brain magnetic resonance image (MRI) is helpful. There is usually an interval until symptoms, such as an altered mental status, develop after trauma. We report a case of cerebral fat embolism in which the patient’s mental status deteriorated several hours after trauma and the initial findings were negative on diffusion-weighted MRI.; Summary

Pulmonary Bone Cement Embolism Following Percutaneous Vertebroplasty: Yong Han Cha; J Trauma Inj. 2015;28(3):202-205. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.202

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PURPOSE
Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable.
CASE
DESCRIPTION: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. LITERATURE REVIEWS: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces.
CONCLUSION
Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.

Summary

Citations

Citations to this article as recorded by

Precooling storage of bone cement in percutaneous vertebroplasty for osteoporotic vertebral compression fracture
Shan-Wen Xiao, Su-Fang Zhou, Shi-Xin Pan, Guo-Dong Li, Quan Li, Ai-Hui Li
BMC Musculoskeletal Disorders.2024;[Epub] CrossRef
Micro- and Nanoparticulate Hydroxyapatite Powders as Fillers in Polyacrylate Bone Cement—A Comparative Study
Anna Sobczyk-Guzenda, Paulina Boniecka, Anna Laska-Lesniewicz, Marcin Makowka, Hieronim Szymanowski
Materials.2020; 13(12): 2736. CrossRef

Original Article

Correlation between Young and Burgess Classification and Transcatheter Angiographic Embolization in Severe Trauma Patients: Yong Han Cha, Young Hoon Sul, Ha Yong Kim, Won Sik Choy; J Trauma Inj. 2015;28(3):144-148. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.144

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Abstract PDF: PURPOSE
Immediate identification of vascular injury requiring embolization in patients with pelvic bone fracture isn't an easy task. There have been many trials finding indicators of embolization for patients with pelvic bone fracture. Although Young and Burgess classification is useful in decision making of treatment, it is reported to have little value as indicator of embolization in major trauma patients. The aim of this study is to find out Young and burgess classification on predicting vessel injury by analzyng pelvic radiograph taken from major trauma patients with pelvic bone fracture.
METHODS
Among major trauma patients with injury severity scores (ISS) higher than 15 who visited our emergency room from January 2011 to June 2014, 200 patients were found with pelvic bone fracture in trauma series and thus pelvic CT angiography was taken. Setting aside patients with exclusion criteria, 153 patients were enrolled in this study for analysis of Young and Burgess classification.
RESULTS
The most common mechanism of injury was lateral compression in both groups. There was no statistical significant difference in Young and Burgess classification (p=0.397). The obturator artery was the most commonly injured artery in both groups. Six patients had more than one site of bleeding.
CONCLUSION
Prediction of transcatheter angiographic embolization using Young and Burgess classification in severe trauma patients is difficult and requires additional studies.; Summary

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