RT Journal Article
SR Electronic
T1 Cerebral fat embolism syndrome (FES): similar cases with different outcomes
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2018-225261
DO 10.1136/bcr-2018-225261
VO 2018
A1 Alexis Jorgensen
A1 Azhar Bashir
A1 Jibanananda Satpathy
YR 2018
UL http://casereports.bmj.com/content/2018/bcr-2018-225261.abstract
AB Fat embolism syndrome (FES) is a rare multisystem, clinical syndrome occurring in 0.9%–2.2% of long-bone fractures. The severity of FES can vary from subclinical with mild respiratory changes and haematological aberrations to a fulminant state characterised by sudden onset of severe respiratory and neurological impairment. Here we present two patients with cerebral FES secondary to femur fracture. Both patients exhibited profound neurological impairment with varied outcomes. Our cases highlight the importance of a high clinical suspicion of FES in patients with long-bone fractures and neurological deterioration. We recommend early plate osteosynthesis to prevent additional emboli in patients with FES and situational placement of intracranial pressure monitoring. Finally, cerebral FES has low mortality even in a patient with tentorial herniation and fixed, dilated pupils.