Case report: Post-traumatic cerebral fat embolism: CT and MR findings. Report of two cases and review of the literature

Chrysikopoulos, H; Maniatis, V.; Pappas, John N.; Filalithis, P.; Gogali, C.; Sfyras, D.

doi:10.1016/s0009-9260(96)80248-0

Cited by 28 publications

(16 citation statements)

References 18 publications

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“…This result suggests that a triolein emulsion infusion causes no ischemic infarction, which is consistent with no significant changes in cerebral hemodynamics after infusion of a triolein emulsion into the carotid artery (23). Thus, the triolein particles used in the present study were too small to cause mechanical vascular occlusion, in agreement with the results of previous studies (6,15).…”

Section: Discussionsupporting

confidence: 93%

Proton magnetic resonance spectroscopic findings of cerebral fat embolism induced by triolein emulsion in cats

Kim

et al. 2008

Acta Radiol

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Section: Discussionsupporting

confidence: 93%

Proton magnetic resonance spectroscopic findings of cerebral fat embolism induced by triolein emulsion in cats

Kim

et al. 2008

Acta Radiol

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“…[2][3][4] Although these mutations are rare, allelic variability within the SNCA promoter may confer PD susceptibility via a mechanism of gene overexpression and protein aggregation. 5,6 At low protein concentrations, the fibrillization of ␣-synuclein is promoted by the interacting microtubule-associated protein tau, 7 and ␣-synuclein and tau pathology may co-occur in PD. 8 Haplotype variability within the microtubule-associated protein…”

Section: Resultsmentioning

confidence: 99%

Cerebral fat embolism: Usefulness of magnetic resonance spectroscopy

Guillevin

Vallée

Demeret

et al. 2005

Annals of Neurology

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We report a case of cerebral fat embolism which occurred in a 33-year-old man after a diaphyseal femoral fracture without cranial traumatism. The initial examination showed an incomplete picture of coma with tetrapyramidal syndrome and cutaneomucous purpura. There was no respiratory damage. We present a magnetic resonance spectroscopy analysis of the cerebral lesions observed in the initial phase of the embolism, as well as follow-up, which has strengthened the clinical and imaging features for the diagnosis.

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“…Although a CT scan sometimes demonstrates findings that can correspond well with cerebral fat embolism, like diffuse edema and low density areas suspect for hemorrhages, the defects are frequently not visualized. [13][14][15] However, a CT scan suits well for exclusion of other causes of central nervous system dysfunction, and in that way can be of great value. 16 Typical MRI findings in the acute stage of cerebral fat embolism consist of patchy lesions throughout the brain, most commonly located in the white matter and subcortical gray matter.…”

Section: Discussionmentioning

confidence: 99%

Fat Embolism Syndrome: Yes or No?

Feiter

Hooft

Beets-Tan

et al. 2007

Journal of Trauma: Injury, Infection &Amp; Critical Care

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F at embolism is defined as a mechanical blockage of blood vessels by circulating fat particles. 1,2 It is sometimes associated with nontraumatic, but mainly with traumatic, conditions 3 and develops in more than 90% of the patients with long-bone fractures as a subclinical event. 2 After a delay of 24 to 48 hours, only 0.5 to 2% of the cases turn into the classic fat embolism syndrome (FES) with respiratory, neurologic, and cutaneous symptoms. [2][3][4] In patients with multiple fractures or pelvic fractures, the incidence is 10 times higher (5-10%). 3 Surgery on the lower extremity also predisposes to FES. 5 The mortality ranges between 5% and 10%, and is related to the severity of FES as well as to associated injuries. 2 Clinical criteria are commonly used for establishment of the diagnosis. 6,7 We report the case of a patient who developed dyspnea and neurologic deterioration after conservative treatment of a tibia fracture. Although this patient did not completely meet the classic criteria, we attribute these symptoms to fat embolism syndrome, and discuss the value of these criteria in relation to modern diagnostic tools like magnetic resonance imaging (MRI) and high resolution computed tomography (CT) scan. Although the incidence of FES is higher in patients with closed fractures, only a few reports deal with this category of patients. 4,8 CASE REPORTA 42-year-old woman was admitted to the hospital with an isolated, midshaft fracture of the right tibia, caused by the kick of a horse. Her medical history revealed a tetralogy of Fallot, which was corrected at the age of 10 years. The fracture was treated by closed reduction under anesthesia and an above-theknee cast. The patient awoke clear-headed from the narcosis. About 36 hours after the procedure, she developed serious respiratory distress with a desaturation below 70% and was admitted to the intensive care department. The blood gas analysis revealed pO 2 of 6.1 kPa, pCO 2 of 5.1 kPa, and pH of 7.39. She was disorientated. After treatment was started with 100% oxygen by facemask, she recovered quickly and blood gas analysis normalized within several hours. On neurologic examination, however, she remained disorientated. The Eye-Motor-Voice score was 4-6-4. Her right arm showed a grade 4 positive Barre and a bilateral positive Babinski reflex was noted. Further clinical examination revealed no abnormalities. In particular, no cutaneous symptoms were seen. The urine production was normal. Except for the bloodgas analysis, the laboratory findings showed no abnormalities. On echocardiography, no intracardial shunt was established. The chest radiograph showed no pathology except for signs compatible with pulmonary hypertension. The CT scan of the chest showed large pulmonary vessels and a bulging right atrium, but no signs of pulmonary artery embolism. In the parenchyma of the lungs diffuse, small infiltrates and ground-glass phenomena were visualized. Magnetic resonance imaging of the brain showed multiple hyperintense areas on T2-weighted images and hypointen...

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Case report: Post-traumatic cerebral fat embolism: CT and MR findings. Report of two cases and review of the literature

Cited by 28 publications

References 18 publications

Proton magnetic resonance spectroscopic findings of cerebral fat embolism induced by triolein emulsion in cats

Proton magnetic resonance spectroscopic findings of cerebral fat embolism induced by triolein emulsion in cats

Cerebral fat embolism: Usefulness of magnetic resonance spectroscopy

Fat Embolism Syndrome: Yes or No?

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