Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Cerebral Fat Embolism after Traumatic Multiple Fracture: A Case Report

외상성 다발성 골절 후 발생한 뇌 지방 색전증 1예

  • Kim, Ho Hyun (Trauma Center of Pusan National University Hospital) ;
  • Park, Yun Chul (Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School) ;
  • Lee, Dong Kyu (Trauma Center of Mokpo Hankuk Hospital) ;
  • Park, Chan Yong (Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School) ;
  • Kim, Jae Hun (Trauma Center of Pusan National University Hospital) ;
  • Kim, Yeong Dae (Trauma Center of Pusan National University Hospital) ;
  • Kim, Jung Chul (Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School)
  • 김호현 (부산대학교병원 외상센터) ;
  • 박윤철 (전남대학교 의과대학 외과학교실 외상외과) ;
  • 이동규 (목포한국병원 외상센터) ;
  • 박찬용 (전남대학교 의과대학 외과학교실 외상외과) ;
  • 김재훈 (부산대학교병원 외상센터) ;
  • 김영대 (부산대학교병원 외상센터) ;
  • 김정철 (전남대학교 의과대학 외과학교실 외상외과)
  • Received : 2013.02.15
  • Accepted : 2013.06.24
  • Published : 2013.06.30
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Abstract

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 posttraumatic cerebral fat embolism without pulmonary involvement and review the existing literature.

Keywords

References

  1. Johnson MJ, Lucas GL. Fat embolism syndrome. Orthopedics 1996; 19: 41-7.
  2. Bardana D, Rudan J, Cervenko F, Smith R. Fat embolism syndrome in a patient demonstrating only neurologic symptoms. Can J Surg 1998; 41: 398-402.
  3. Muller C, Rahn BA, Pfister U, Meinig RP. The incidence, pathogenesis, diagnosis, and treatment of fat embolism. Orthop Rev 1994; 23: 107-17.
  4. Park SJ, Sung DW, Jun YH, Oh JH, Ko YT, Lee JH, et al. Pulmonary Fat Embolism Induced Intravenous Injection of Autologous Bone Marrow in Rabbit: CT and Pathologic Correlation. J Korean Radiol Soc 1999; 41: 303-11. https://doi.org/10.3348/jkrs.1999.41.2.303
  5. Akhtar S. Fat embolism. Anesthesiol Clin 2009; 27: 533-50. https://doi.org/10.1016/j.anclin.2009.07.018
  6. Gurd AR. Fat embolism: an aid to diagnosis. J Bone Joint Surg Br 1970; 52: 732-7.
  7. Saito A, Meguro K, Matsumura A, Komatsu Y, Oohashi N. Magnetic resonance imaging of a fat embolism of the brain: case report. Neurosurgery 1990; 26: 882-4. https://doi.org/10.1227/00006123-199005000-00027
  8. Sakamoto T, Sawada Y, Yukioka T, Yoshioka T, Sugimoto T, Taneda M. Computed tomography for diagnosis and assessment of cerebral fat embolism. Neuroradiology 1983; 24: 283- 5. https://doi.org/10.1007/BF00333182
  9. Parizel PM, Demey HE, Veeckmans G, Verstreken F, Cras P, Jorens PG, et al. Early diagnosis of cerebral fat embolism syndrome by diffusion-weighted MRI (starfield pattern). Stroke 2001; 32: 2942-4.
  10. Bryan RN, Levy LM, Whitlow WD, Killian JM, Preziosi TJ, Rosario JA. Diagnosis of acute cerebral infarction: Comparision of CT and MR imaging. AJNR Am J Neuroradiol 1991; 12: 611-20.
  11. Kim HJ, Lee CH, Lee SH, Cho BM, Kim HK, Park BR, et al. Early development of vasogenic edema in experimental cerebral fat embolism in cat. Invest Radiol 2001; 36: 460-9. https://doi.org/10.1097/00004424-200108000-00005
  12. Kawano Y, Ochi M, Hayashi K, Morikawa M, Kimura S. Magnetic resonance imaging of cerebral fat embolism. Neuroradiology 1991; 33: 72-4. https://doi.org/10.1007/BF00593341
  13. Schoneld SA, Ploysongsang Y, DiLisio R, Crissman JD, Miller E, Hammerschmidt DE, et al. Fat embolism prophylaxis with corticosteroids. A prospective study in high risk patients. Ann Intern Med 1983; 99: 438-43. https://doi.org/10.7326/0003-4819-99-4-438
  14. Habashi NM, Andrews PL, Scalea TM. Therapeutic aspects of fat embolism syndrome. Injury. 2006; 37 Suppl 4: S68-73. https://doi.org/10.1016/j.injury.2006.08.042
  15. Takahashi M, Suzuki R, Osakabe Y, Asai JI, Miyo T, Nagashima G, et al. Magnetic resonance imaging findings in cerebral fat embolism: correlation with clinical manifestations. J Trauma 1999; 46: 324-7. https://doi.org/10.1097/00005373-199902000-00021