Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
Journal
Journal of International Medical Research
Journal Volume
49
Journal Issue
7
Date Issued
2021
Author(s)
Abstract
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. ? The Author(s) 2021.
Subjects
case report
Fat embolism syndrome
Glasgow coma scale
Gurd’s criteria
magnetic resonance imaging
tibial plateau fracture
acetylsalicylic acid
antibiotic agent
C reactive protein
ceftazidime
creatinine
D dimer
dexamethasone
fibrinogen
vancomycin
acute cerebral fat embolism
aged
anemia
Article
bone allograft
brain embolism
clinical article
computer assisted tomography
creatinine blood level
diffusion weighted imaging
echocardiography
elevated blood pressure
epidural anesthesia
evaluation and follow up
female
fever
fibrinogen blood level
fibrinolysis
hospital discharge
human
hypertension
injury scale
intensive care unit
late onset disorder
medical history
neurologic examination
nuclear magnetic resonance imaging
open reduction (procedure)
osteosynthesis
outcome assessment
paraplegia
parkinsonism
physical examination
plate fixation
postoperative care
preoperative evaluation
protein blood level
radiography
Staphylococcus capitis
surgical debridement
surgical infection
tachycardia
traffic accident
treatment outcome
unconsciousness
wound infection
complication
diagnostic imaging
fat embolism
fracture fixation
tibia fracture
Aged
Embolism, Fat
Female
Fracture Fixation
Humans
Intracranial Embolism
Magnetic Resonance Imaging
Tibial Fractures
SDGs
Type
journal article