Posttraumatic Paradoxical Fat Embolism to the Brain: A Case Report

Nastanski, F; Gordon, W Ian; Lekawa, Michael

doi:10.1097/01.ta.0000108996.10785.0b

Cited by 15 publications

(6 citation statements)

References 15 publications

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“…The incidence of intracardiac shunts has been described to occur in 20–34% of the population. [3] Additionally, microfat droplets can theoretically traverse the pulmonary circulation without sequestration, resulting in systemic symptoms. [23]…”

Section: Discussionmentioning

confidence: 99%

“…It is difficult to identify this disorder upon acute presentation of trauma patients secondary to the multiplicity of injuries and manifestation of symptoms. [23] A case report of a post-traumatic death caused by acute dissemination of fat emboli to the brain and lungs in the absence of a right-to-left heart defect after femur diaphyseal fracture is presented.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral fat embolism without intracardiac shunt: A novel presentation

Eriksson

Schultz

Cohle³

et al. 2011

J Emerg Trauma Shock

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Fat embolism syndrome (FES) is defined as an uncommon life-threatening disease process consisting of pulmonary, central nervous system (CNS), and cutaneous manifestations. The pathophysiology of this secondary injury is poorly understood. In the setting of the multiply injured patient, the diagnosis of FES is difficult to ascertain. A case report of a posttraumatic death caused by acute dissemination of diffuse fat emboli to the brain and lungs in the absence of a right-to-left heart defect after femur fracture is presented. The transesophageal echo cardiogram with bubble study failed to demonstrate an intracardiac defect or AV malformation in the lung further supporting a biochemical process. The acute decompensation of the patient within 2 h of the injury would favor mechanical emboli. Supportive care continues to be the mainstay of treatment for FES. Cerebral fat embolism should be considered in traumatically injured patients with unexplained decline in their neurologic examination. Cerebral fat embolism may occur without an intracardiac shunt.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cerebral fat embolism without intracardiac shunt: A novel presentation

Eriksson

Schultz

Cohle³

et al. 2011

J Emerg Trauma Shock

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“…Traumatic injury causes plasma lipase levels to rise, increasing the release of free fatty acids and resulting in altered fat homeostasis. Consequently, fat droplets are further formed and subsequently sequestered in the microvasculature [10]. An inflammatory reaction in the microvasculature is proposed to ensue from free fatty acid release, resulting in intensified end-organ dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Fat Embolism Syndrome from Penetrating Trauma: A Rare Cause-and-Effect

Gleich¹,

Hannon²

2013

OJAnes

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A 42 year-old male sustained an accidental rifle gunshot wound to his left foot, resulting in fracture deformities of the calcaneus, navicular, cuneiform, 1^st and 2^nd metatarsal bases, and talus. As he was transported to our trauma center, he developed progressive encephalopathy. Urgent external fixator placement under general anesthesia was postponed due to his encephalopathy of unknown etiology. Brain magnetic resonance imaging demonstrated a “starfield” pattern of infarcts, consistent with cerebral fat embolism syndrome. Subsequently, he underwent uneventful general anesthesia. The patient was managed supportively and continued to have persistent neurologic dysfunction two months after injury.

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“…İntraoperatif ortopedik manüplasyon süresince yapılan gözlemler bu embolik teoriyi destekler. Embolik partiküller PFO, atriyal septal defekt veya ventriküler septal defekt gibi intrakardiyak şant ya da pulmoner arteriyo venöz malformasyon yolu ile sistemik dolaşıma geçerek santral sinir sistemi, renal, retinal ve kutanöz bulgulara yol açar (7). İntrakardiyak şantın toplumun %17-35'inde görüldüğü saptanmıştır (8).…”

Section: Olgu Sunumuunclassified