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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
  • 3,037 View
  • 76 Download
AbstractAbstract 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
Rare Imaging of Fat Embolism Seen on Computed Tomography in the Common Iliac Vein after Polytrauma
Hojun Lee, Jonghwan Moon, Junsik Kwon, John Cook-Jong Lee
J Trauma Inj. 2018;31(2):103-106.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.103
  • 4,404 View
  • 58 Download
  • 1 Citations
AbstractAbstract PDF

Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of ?86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

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  • Fat embolism in the popliteal vein detected on CT: Case report and review of the literature
    Tucker Burr, Hamza Chaudhry, Cheryl Zhang, Vasilios Vasilopoulos, Emad Allam
    Radiology Case Reports.2020; 15(11): 2308.     CrossRef
Traumatic Extrapleural Hematoma Mimicking Hemothorax
Yong Seon Choi, Soon Jin Kim, Sang Woo Ryu, Seung Ku Kang
J Trauma Inj. 2017;30(4):202-205.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.202
  • 6,819 View
  • 107 Download
  • 1 Citations
AbstractAbstract PDF

After blunt chest injuries, extrapleural hematoma may result in a collection of blood between the parietal pleura and the endothoracic fascia. Extrapleural hematoma is frequently misdiagnosed as hemothorax. Extrapleural fat sign, the inward displacement of strip of extrapleural fat on computed tomography, is typical radiological findings of extrapleural hematoma. We encountered a case of extrapleural hematoma with a presentation similar to hemothorax after blunt chest injury.

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  • Hemothorax or not: Use of extrapleural fat sign
    Rajat Dahiya, Thaker Nirav, Jaggi Sunila, Talwar Inder
    West African Journal of Radiology.2021; 28(1): 18.     CrossRef
Fat Embolism Syndrome - Three Case Reports and Review of the Literature
Leonidas Grigorakos, Ioannis Nikolopoulos, Stamatina Stratouli, Anastasia Alexopoulou, Eleftherios Nikolaidis, Eleftherios Fotiou, Daria Lazarescu, Ioannis Alamanos
J Trauma Inj. 2017;30(3):107-111.   Published online October 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.3.107
  • 2,988 View
  • 67 Download
  • 1 Citations
AbstractAbstract PDF
The fat embolism syndrome (FES) represents a condition, usually with traumatic etiology, which may pose challenges to diagnosis while its treatment usually requires supportive measures in the intensive care units (ICUs). The clinical criteria, including respiratory and cerebral dysfunction and a petechial rash, along with imaging studies help in diagnosis. Here we present three case reports of young male who developed FES and were admitted to our ICUs after long bones fractures emerging after vehicle crashes and we briefly review FES literature. All patients' treatment was directed towards: 1) the restoration of circulating volume with fresh blood and/or plasma; 2) the correction of acidosis; and 3) immobilization of the affected part. All patients recovered and were released to the orthopedic wards. The incidence of cases of patients with FES admitted in our ICUs records a significant decrease. This may be explained in terms effective infrastructure reforms in Greece which brought about significant improvement in early prevention and management.
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  • Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
    Ta-Li Hsu, Tien-Chi Li, Fei-Pi Lai, Ming Ouhyoung, Chih-Hung Chang, Cheng-Tzu Wang
    Journal of International Medical Research.2021; 49(7): 030006052110284.     CrossRef
Cerebral Fat Embolism after Traumatic Multiple Fracture: A Case Report
Ho Hyun Kim, Yun Chul Park, Dong Kyu Lee, Chan Yong Park, Jae Hun Kim, Yeong Dae Kim, Jung Chul Kim
J Trauma Inj. 2013;26(2):58-62.
  • 1,188 View
  • 8 Download
AbstractAbstract PDF
A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a post-traumatic cerebral fat embolism without pulmonary involvement and review the existing literature.
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J Trauma Inj : Journal of Trauma and Injury