https://scholars.lib.ntu.edu.tw/handle/123456789/607253
標題: | Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report | 作者: | Hsu T.-L Li T.-C Lai F.-P Ouhyoung M Chang C.-H Wang C.-T. MING OUHYOUNG |
關鍵字: | 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 | 公開日期: | 2021 | 卷: | 49 | 期: | 7 | 來源出版物: | Journal of International Medical Research | 摘要: | 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. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85110946089&doi=10.1177%2f03000605211028415&partnerID=40&md5=44afcc34ede3a3abaccc507b36e9668e https://scholars.lib.ntu.edu.tw/handle/123456789/607253 |
ISSN: | 03000605 | DOI: | 10.1177/03000605211028415 |
顯示於: | 電機工程學系 |
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