Neurologic Complications of Fat Embolism Syndrome

Morales-Vidal, Sarkis

doi:10.1007/s11910-019-0928-9

Cited by 19 publications

(21 citation statements)

References 51 publications

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“…[6] Currently, for the definite diagnosis of FES, clinicians may choose one from the diagnostic criteria defined by Schonfeld, Gurd, or Lindeque. [1] Our case does not fulfill the classical criteria for the diagnosis of FES. However, sudden visual loss after the bone fracture, normal retinal examination, and bilateral reactive pupils, diffuse multiple cortical and subcortical embolic hyperintensities suggest a CFES.…”

Section: Discussionmentioning

confidence: 64%

“…However, the routine administration of heparin for FES is not recommended. [1] An old double-blinded, randomized trial showed that treatment with methylprednisolone stabilized or reduced serum levels of free fatty acids, maintained arterial oxygen levels, and significantly decreased the risk of FES. The most crucial step for supportive treatment is the early resuscitation and stabilization of hypovolemia to minimize stress.…”

Section: Discussionmentioning

confidence: 99%

“…The reported risk of FES following orthopedic trauma ranges between 1 to 30%. [1] The classical triad of FES includes respiratory insufficiency, neurological impairment, and petechial skin rash. [2] It usually occurs 24 to 72 h following the initial insult.…”

mentioning

confidence: 99%

“…[2] It usually occurs 24 to 72 h following the initial insult. [1] The clinical entity in which neurological signs and symptoms predominate is defined as cerebral FES (CFES). Neurological complications of CFES include ischemic or hemorrhagic strokes with focal neurological deficits, headache, apraxia, vision loss, seizures, convulsive and non-convulsive status epilepticus, autonomic dysfunction, acute encephalopathy, confusion, and coma.…”

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confidence: 99%

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Transient cortical blindness due to cerebral fat embolism

Doğan

Niyaz

2022

Jt Dis Relat Surg Case Rep

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Joint Diseases and Related Surgery Case ReportsFat embolism syndrome (FES) is a rare disorder most commonly manifested with respiratory insufficiency following long bone fractures or orthopedic surgery. The reported risk of FES following orthopedic trauma ranges between 1 to 30%. [1] The classical triad of FES includes respiratory insufficiency, neurological impairment, and petechial skin rash. [2] It usually occurs 24 to 72 h following the initial insult. [1] The clinical entity in which neurological signs and symptoms predominate is defined as cerebral FES (CFES). Neurological complications of CFES include ischemic or hemorrhagic strokes with focal neurological deficits, headache, apraxia, vision loss, seizures, convulsive and non-convulsive status epilepticus, autonomic dysfunction, acute encephalopathy, confusion, and coma. [3,4] Given the wide range of clinical signs and symptoms, the diagnosis depends on excluding other causes in high-risk patients with a history of trauma and surgery.Fat embolism syndrome (FES) is a disease that manifests with respiratory distress, neurological impairment, and petechial rash and develops due to embolization of fat particles into several organs after long bone fractures or orthopedic surgery. A 26-year-old male patient developed sudden vision loss 24 h after the tibial fracture. Except for visual acuity, other neurological and ophthalmological examinations were normal. He had transient cortical blindness due to central fat embolism secondary to dislocated tibia fracture. Although the major diagnostic criteria of FES include at least two skin, pulmonary and neurological involvements, cerebral fat embolism may occur alone without any additional organ involvement. Multiple brain fat embolism may lead to cortical blindness, which is usually transient.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Transient cortical blindness due to cerebral fat embolism

Doğan

Niyaz

2022

Jt Dis Relat Surg Case Rep

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“…Biological results are nonspecific. Common blood disorders in FES are thrombocytopenia and hemolytic anemia [9].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Cerebral Fat Embolism With No Respiratory or Dermatologic Involvement

Salimi¹,

Ali²,

Tazi³

et al. 2022

Cureus

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Fat embolism syndrome is potentially lethal. It is frequently a complication of long bone fractures and/or orthopedic surgery. Cerebral fat embolism is an unusual condition characterized by purely cerebral involvement. Neurological signs can be variable and brain MRI has a pivotal role in the diagnosis. We report the case of a 69-year-old male who presented motor impairment and a disorder of consciousness in the early postoperative course of total hip arthroplasty for a left femoral neck fracture, which occurred 24 hours before surgery. He had no dermatologic or respiratory signs. No respiratory or dermatologic signs were found. Blood samples showed moderate thrombopenia and hemolytic anemia. Multiple lesions were found on brain MRI. Diagnosis of cerebral fat embolism was established after ruling out differentials.

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Stars from the bones—An uncommon presentation of fat embolism syndrome

Sivanandam

Gupta

Rahim

et al. 2023

Clinical Case Reports

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Trauma or surgery to the lower limbs can cause fat from the marrow within the leg bones to enter the bloodstream and form an embolus. However, if there is cerebral involvement without any pulmonary or dermatological manifestations at diagnosis, it could delay identifying cerebral fat embolism (CFE). K E Y W O R D Scerebral fat embolism (CFE), fat embolism syndrome, long bone fracture, star field pattern, traumaThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Neurologic Complications of Fat Embolism Syndrome

Cited by 19 publications

References 51 publications

Transient cortical blindness due to cerebral fat embolism

Transient cortical blindness due to cerebral fat embolism

A Rare Case of Cerebral Fat Embolism With No Respiratory or Dermatologic Involvement

Stars from the bones—An uncommon presentation of fat embolism syndrome

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