Therapeutic aspects of fat embolism syndrome.

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Abstract

[Indexed for MEDLINE] 13. J Emerg Med. 2022 Oct;63(4):e87-e90. doi: 10.1016/j.jemermed.2022.07.006. Epub 2022 Oct 13. Cerebral Fat Embolism After a Fall. Gibbons P(1), Kennedy M(2), Borczuk P(3), Baymon D(4). Author information: (1)Department of Emergency Medicine, Combined Massachusetts General Hospital and Brigham and Women's Hospital, Boston, Massachusetts. (2)Division of Geriatric Emergency Medicine, Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts. (3)Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts. (4)Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts. BACKGROUND: Cerebral fat embolism is a rare diagnosis that can occur after significant long bone trauma. Most patients have evidence of pulmonary involvement, but this case involved a patient with a pure neurologic manifestation of a fat embolism. CASE REPORT: An 89-year-old woman presented to the emergency department as a transfer from an outside hospital with a diagnosis of air embolism after an episode of altered mental status and expressive aphasia. A secondary review of the patient's computed tomography angiography head imaging uncovered a cerebral fat embolism as the cause of the patient's acute neurologic event. The cerebral fat embolism was likely from a remote sacral fracture 6 weeks prior. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When a patient presents with a concern for a stroke-like symptoms and a cerebral fat embolism is diagnosed, a thorough examination of the patient must be performed to identify the primary fracture site. Geriatric long bone fractures have well-known significant morbidity and mortality. An associated cerebral fat embolism can increase that mortality and morbidity and prompt diagnosis is important. Copyright © 2022. Published by Elsevier Inc. DOI: 10.1016/j.jemermed.2022.07.006