Cerebral Fat Embolism

Gupta, Babita; Kaur, Manpreet; D’souza, Nita; Dey, Chandan Kumar; Shende, Seema; Kumar, Atin; Gamangatti, Shivanand

doi:10.4103/1658-354x.84122

Cited by 21 publications

(16 citation statements)

References 13 publications

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“…Cerebral fat embolism has been reported in young adults between 18 and 39 years 561012131415161718192021. The two patients, we report here are also in the same age group.…”

Section: Discussionsupporting

confidence: 66%

“…This was seen in our cases also where they were completely normal neurologically at presentation and rapidly deteriorated in the next 9-12 h. Diagnosis of fat embolism syndrome is by and large clinical and is characterized by the classical triad of petechial rash, respiratory distress and neurological dysfunction 9. However, this triad may not be present in all patients and poses a diagnostic challenge 10. Both our cases had profound neurological dysfunction at presentation, but had no petechial rash.…”

Section: Discussionsupporting

confidence: 56%

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Late recovery in cerebral fat embolism

Sundararajan

Rajasekaran

2014

IJOO

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Fat embolism syndrome presenting primarily with cerebral manifestations is rarely reported. We report here two such patients who showed complete recovery following initial deterioration. The aim of these reports is to highlight that prolonged intensive care and good rehabilitation can lead to normal neurologic recovery despite poor clinical picture initially. The importance of adequate oxygenation to prevent secondary brain damage is emphasized during prolonged recovery.

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“…Cerebral fat embolism has been reported in young adults between 18 and 39 years 561012131415161718192021. The two patients, we report here are also in the same age group.…”

Section: Discussionsupporting

confidence: 66%

Section: Discussionsupporting

confidence: 56%

Late recovery in cerebral fat embolism

Sundararajan

Rajasekaran

2014

IJOO

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“…In our patient, there was no cerebral involvement from presentation to recovery. Despite the fact, we monitored our patient with pupil examination and wake up test at frequent intervals while he was prone keeping in mind the grave consequences of cerebral fat embolism that could have met us while managing our patient [13,14].…”

Section: Discussionmentioning

confidence: 99%

Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature

Tyagi¹,

Aggarwal²,

Soni³

et al. 2019

BEAT

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Fat embolism syndrome is a rare but fatal complication seen commonly in patients with polytrauma. Its earliest manifestation is hypoxemia due to deposition of fat globules in pulmonary circulation which can progress to severe acute respiratory distress syndrome, the treatment of which is mainly supportive. We describe the case of a 17-year-old male who was admitted in our intensive care unit (ICU) for severe hypoxemia due to fat embolism. He had burst fracture of 5th lumbar vertebra with canal compromise along with other fractures. Failing conventional ventilation, the patient was placed in prone position taking proper precautions in positioning giving due consideration to his unstable lumbar spine. There was no neurological insult and in the next two days, he was weaned off from the ventilator. Though prone position is relatively contraindicated in patients with unstable spine, we employed early prone positioning taking adequate precautions, the benefit of which we believe outweighed the risk.

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“…In our case, the absence of cutaneous manifestation did not fulfill any of the criteria used for the diagnosis of FES. [ 5 ] Moreover, the initial cranial CT scan finding of hypodense of lacunar lesion pointed towards stroke being the cause of neurological deterioration. The decline in respiratory and cardiac status was attributed to possible brain stem stroke or infections.…”

Section: Discussionmentioning

confidence: 99%

Cerebral fat embolism: Use of MR spectroscopy for accurate diagnosis

Kokatnur

Rudrappa

Khasawneh

2015

Ann Indian Acad Neurol

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Cerebral fat embolism (CFE) is an uncommon but serious complication following orthopedic procedures. It usually presents with altered mental status, and can be a part of fat embolism syndrome (FES) if associated with cutaneous and respiratory manifestations. Because of the presence of other common factors affecting the mental status, particularly in the postoperative period, the diagnosis of CFE can be challenging. Magnetic resonance imaging (MRI) of brain typically shows multiple lesions distributed predominantly in the subcortical region, which appear as hyperintense lesions on T2 and diffusion weighted images. Although the location offers a clue, the MRI findings are not specific for CFE. Watershed infarcts, hypoxic encephalopathy, disseminated infections, demyelinating disorders, diffuse axonal injury can also show similar changes on MRI of brain. The presence of fat in these hyperintense lesions, identified by MR spectroscopy as raised lipid peaks will help in accurate diagnosis of CFE. Normal brain tissue or conditions producing similar MRI changes will not show any lipid peak on MR spectroscopy. We present a case of CFE initially misdiagnosed as brain stem stroke based on clinical presentation and cranial computed tomography (CT) scan, and later, MR spectroscopy elucidated the accurate diagnosis.

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Cerebral Fat Embolism

Cited by 21 publications

References 13 publications

Late recovery in cerebral fat embolism

Late recovery in cerebral fat embolism

Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature

Cerebral fat embolism: Use of MR spectroscopy for accurate diagnosis

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