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一例罕见的无呼吸或皮肤受累的脑脂肪栓塞病例。

A Rare Case of Cerebral Fat Embolism With No Respiratory or Dermatologic Involvement.

作者信息

Salimi Zakaria, Ami Ali Mehdi, Tazi Rim, Mimouni Yasmine, Hazim Asmaa, Aasfara Jehanne

机构信息

Neurology, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Emergency Medicine, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

出版信息

Cureus. 2022 Feb 14;14(2):e22192. doi: 10.7759/cureus.22192. eCollection 2022 Feb.

DOI:10.7759/cureus.22192
PMID:35308671
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8926028/
Abstract

Fat embolism syndrome is potentially lethal. It is frequently a complication of long bone fractures and/or orthopedic surgery. Cerebral fat embolism is an unusual condition characterized by purely cerebral involvement. Neurological signs can be variable and brain MRI has a pivotal role in the diagnosis. We report the case of a 69-year-old male who presented motor impairment and a disorder of consciousness in the early postoperative course of total hip arthroplasty for a left femoral neck fracture, which occurred 24 hours before surgery. He had no dermatologic or respiratory signs. No respiratory or dermatologic signs were found. Blood samples showed moderate thrombopenia and hemolytic anemia. Multiple lesions were found on brain MRI. Diagnosis of cerebral fat embolism was established after ruling out differentials.

摘要

脂肪栓塞综合征有潜在致死性。它常为长骨骨折和/或骨科手术的并发症。脑脂肪栓塞是一种不常见的情况，其特征为仅累及脑部。神经体征可能多变，脑部磁共振成像（MRI）在诊断中起关键作用。我们报告一例69岁男性病例，该患者在因左股骨颈骨折行全髋关节置换术后早期出现运动障碍和意识障碍，骨折发生于手术前24小时。他没有皮肤或呼吸方面的体征。未发现呼吸或皮肤体征。血样检查显示中度血小板减少和溶血性贫血。脑部MRI发现多个病灶。排除其他鉴别诊断后确诊为脑脂肪栓塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/421705b251f8/cureus-0014-00000022192-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/4bc59165ae7a/cureus-0014-00000022192-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/ff27bc79ebf1/cureus-0014-00000022192-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/42fee592be58/cureus-0014-00000022192-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/421705b251f8/cureus-0014-00000022192-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/4bc59165ae7a/cureus-0014-00000022192-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/ff27bc79ebf1/cureus-0014-00000022192-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/42fee592be58/cureus-0014-00000022192-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9d/8926028/421705b251f8/cureus-0014-00000022192-i04.jpg

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From the diagnosis to the therapeutic management: cerebral fat embolism, a clinical challenge.从诊断到治疗管理：脑脂肪栓塞，一项临床挑战。
Int J Gen Med. 2019 Jan 4;12:39-48. doi: 10.2147/IJGM.S177407. eCollection 2019.
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Fat Embolism Syndrome.脂肪栓塞综合征
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