Buskens Christianne J, Gratama Jan Willem C, Hogervorst Mike, van Leeuwen Roeland B, Rommes Johannes H, Spronk Peter E
Department of Surgery, Gelre Ziekenhuizen, Apeldoorn, The Netherlands.
Med Sci Monit. 2008 Nov;14(11):CS125-9.
Fat embolization and fat embolism syndrome are poorly understood complications of skeletal trauma. Fat embolism syndrome is a clinical diagnosis, and patients typically present with a classic triad of petechial rash, pulmonary distress, and neurologic dysfunction. The incomplete form of the syndrome (i.e., cerebral fat embolism) is a more challenging clinical diagnosis in which brain magnetic resonance imaging may be a valuable tool. Fat embolism syndrome can be a life-threatening condition, but the latent form that occurs 24 to 72 hours after the trauma is frequently described as a self-limiting condition.
In this report, we present the case of a 32-year-old man with fat embolism syndrome and a prolonged coma with persistent cerebral dysfunction. Brain magnetic resonance imaging revealed multiple white and grey matter lesions suggestive of vasogenic edema and punctuate hemorrhage, consistent with a diagnosis of cerebral fat emboli.
The pathogenesis and treatment options of fat embolism syndrome are reviewed based on available literature, and the usefulness of brain magnetic resonance imaging is discussed.
脂肪栓塞和脂肪栓塞综合征是骨骼创伤中了解较少的并发症。脂肪栓塞综合征是一种临床诊断，患者通常表现为典型的三联征，即瘀点皮疹、肺部窘迫和神经功能障碍。该综合征的不完全形式（即脑脂肪栓塞）是一种更具挑战性的临床诊断，其中脑磁共振成像可能是一种有价值的工具。脂肪栓塞综合征可能是一种危及生命的疾病，但创伤后24至72小时出现的潜伏形式通常被描述为自限性疾病。
在本报告中，我们介绍了一名32岁男性脂肪栓塞综合征患者，该患者长期昏迷且伴有持续性脑功能障碍。脑磁共振成像显示多个白质和灰质病变，提示血管源性水肿和点状出血，符合脑脂肪栓塞的诊断。
根据现有文献对脂肪栓塞综合征的发病机制和治疗选择进行了综述，并讨论了脑磁共振成像的实用性。
