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Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report

Fat embolism syndrome (FES) is a complication of long bone fractures that often occurs within 72 hours of injury. Early-onset isolated cerebral fat embolism is catastrophic and rarely reported. We herein present a rare case of delayed-onset isolated cerebral FES that developed 10 days after definite...

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Autores principales: Hsu, Ta-Li, Li, Tien-Chi, Lai, Fei-Pi, Ouhyoung, Ming, Chang, Chih-Hung, Wang, Cheng-Tzu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295961/
https://www.ncbi.nlm.nih.gov/pubmed/34282643
http://dx.doi.org/10.1177/03000605211028415
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author Hsu, Ta-Li
Li, Tien-Chi
Lai, Fei-Pi
Ouhyoung, Ming
Chang, Chih-Hung
Wang, Cheng-Tzu
author_facet Hsu, Ta-Li
Li, Tien-Chi
Lai, Fei-Pi
Ouhyoung, Ming
Chang, Chih-Hung
Wang, Cheng-Tzu
author_sort Hsu, Ta-Li
collection PubMed
description Fat embolism syndrome (FES) is a complication of long bone fractures that often occurs within 72 hours of injury. Early-onset isolated cerebral fat embolism is catastrophic and rarely reported. We herein present a rare case of delayed-onset isolated cerebral FES that developed 10 days after definite fixation of a left tibial plateau fracture. A 70-year-old woman was injured in a traffic accident and diagnosed with a left tibial plateau fracture. However, she developed sudden loss of consciousness (E4V1M1) and quadriplegia 10 days after fracture fixation. Her vital signs showed no respiratory distress. Diagnosis of isolated cerebral FES was made based on magnetic resonance imaging of the brain, the findings of which were compatible with the clinical neurological findings. After supportive care and rehabilitation, her consciousness became clear on the second day of admission, and her consciousness changed to E4V5M6. She gradually regained strength in her right limbs but had residual left limb paraplegia. Isolated cerebral FES should always be considered for patients who develop a change in consciousness, even beyond 72 hours after injury. Imaging may not initially show definitive abnormalities. Repeated magnetic resonance imaging should be considered if the initial clinical presentation does not fully meet Gurd’s criteria.
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spelling pubmed-82959612021-08-03 Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report Hsu, Ta-Li Li, Tien-Chi Lai, Fei-Pi Ouhyoung, Ming Chang, Chih-Hung Wang, Cheng-Tzu J Int Med Res Case Reports Fat embolism syndrome (FES) is a complication of long bone fractures that often occurs within 72 hours of injury. Early-onset isolated cerebral fat embolism is catastrophic and rarely reported. We herein present a rare case of delayed-onset isolated cerebral FES that developed 10 days after definite fixation of a left tibial plateau fracture. A 70-year-old woman was injured in a traffic accident and diagnosed with a left tibial plateau fracture. However, she developed sudden loss of consciousness (E4V1M1) and quadriplegia 10 days after fracture fixation. Her vital signs showed no respiratory distress. Diagnosis of isolated cerebral FES was made based on magnetic resonance imaging of the brain, the findings of which were compatible with the clinical neurological findings. After supportive care and rehabilitation, her consciousness became clear on the second day of admission, and her consciousness changed to E4V5M6. She gradually regained strength in her right limbs but had residual left limb paraplegia. Isolated cerebral FES should always be considered for patients who develop a change in consciousness, even beyond 72 hours after injury. Imaging may not initially show definitive abnormalities. Repeated magnetic resonance imaging should be considered if the initial clinical presentation does not fully meet Gurd’s criteria. SAGE Publications 2021-07-20 /pmc/articles/PMC8295961/ /pubmed/34282643 http://dx.doi.org/10.1177/03000605211028415 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Reports
Hsu, Ta-Li
Li, Tien-Chi
Lai, Fei-Pi
Ouhyoung, Ming
Chang, Chih-Hung
Wang, Cheng-Tzu
Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
title Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
title_full Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
title_fullStr Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
title_full_unstemmed Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
title_short Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
title_sort late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295961/
https://www.ncbi.nlm.nih.gov/pubmed/34282643
http://dx.doi.org/10.1177/03000605211028415
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