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eISSN: 1643-3750

Encephalopathy and MRI abnormalities in fat embolism syndrome: a case report

Christianne J. Buskens, Jan Willem C. Gratama, Mike Hogervorst, Roeland B. van Leeuwen, Johannes H. Rommes, Peter E. Spronk

Med Sci Monit 2008; 14(11): CS125-129

ID: 869428

Available online: 2008-10-27

Published: 2008-10-27

Background: Fat embolization and fat embolism syndrome are poorly understood complications of skeletal trauma. Fat embolism syndrome is a clinical diagnosis, and patients typically present with a classic triad of petechial rash, pulmonary distress, and neurologic dysfunction. The incomplete form of the syndrome (i.e., cerebral fat embolism) is a more challenging clinical diagnosis in which brain magnetic resonance imaging may be a valuable tool. Fat embolism syndrome can be a life-threatening condition, but the latent form that occurs 24 to 72 hours after the trauma is frequently described as a self-limiting condition.
Material and Method: In this report, we present the case of a 32-year-old man with fat embolism syndrome and a prolonged coma with persistent cerebral dysfunction. Brain magnetic resonance imaging revealed multiple white and grey matter lesions suggestive of vasogenic edema and punctuate hemorrhage, consistent with a diagnosis of cerebral fat emboli.
Conclusions: The pathogenesis and treatment options of fat embolism syndrome are reviewed based on available literature, and the usefulness of brain magnetic resonance imaging is discussed.

Keywords: Magnetic Resonance Imaging, Embolism, Fat - pathology, Syndrome, Brain Damage, Chronic - pathology, Adult