Metting Zwany, Rödiger Lars A, Regtien Joost G, van der Naalt Joukje
Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Clin Neurol Neurosurg. 2009 Sep;111(7):597-600. doi: 10.1016/j.clineuro.2009.03.005. Epub 2009 Apr 24.
To describe a case of a young man with delayed coma after mild head injury, suggestive of cerebral fat embolism (CFE). To underline the value of MR imaging in the differential diagnosis of secondary deterioration in mild head injury.
A 21-year-old man admitted with mild head injury after a fall with facial fractures and long bone fractures. He was admitted to the intensive care unit and was mechanically ventilated. Weaning was not possible because of desaturations and pulmonary congestion. Low platelet count and anaemia developed. On several time points during his admission cerebral imaging data were obtained. Non-contrast CT on admission was normal while follow-up MRI showed extensive white matter abnormalities. These imaging abnormalities combined with the clinical presentation suggests cerebral fat embolism (CFE) as the most likely cause of secondary deterioration in our patient.
In head injured patients with long bone fractures one should consider cerebral fat embolism. When the classical clinical syndrome is not present, MR imaging is warranted for diagnosis and to exclude other causes of secondary deterioration.
描述一例轻度头部受伤后出现延迟性昏迷的年轻男性病例，提示为脑脂肪栓塞（CFE）。强调磁共振成像（MR成像）在轻度头部受伤继发性病情恶化鉴别诊断中的价值。
一名21岁男性因跌倒致面部骨折和长骨骨折后出现轻度头部受伤入院。他被收入重症监护病房并接受机械通气。由于血氧饱和度下降和肺充血，无法撤机。出现了血小板计数低和贫血。在其住院期间的几个时间点获取了脑部成像数据。入院时的非增强CT正常，而后续的MRI显示广泛的白质异常。这些成像异常与临床表现相结合提示脑脂肪栓塞（CFE）是我们患者继发性病情恶化最可能的原因。
在伴有长骨骨折的头部受伤患者中应考虑脑脂肪栓塞。当不存在典型临床综合征时，有必要进行MR成像以进行诊断并排除继发性病情恶化的其他原因。
