Algahtani Hussein A, Shirah Bader H, Abdelghaffar Nawal, Alahmari Fawziah, Alhadi Wajd, Alqahtani Saeed A
Neurology Section, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Research Office King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
J Yeungnam Med Sci. 2023 Apr;40(2):207-211. doi: 10.12701/jyms.2022.00360. Epub 2022 Sep 7.
Fat embolism syndrome is a rare but alarming, life-threatening clinical condition attributed to fat emboli entering the circulation. It usually occurs as a complication of long-bone fractures and joint reconstruction surgery. Neurological manifestations usually occur 12 to 72 hours after the initial insult. These neurological complications include cerebral infarction, spinal cord ischemia, hemorrhagic stroke, seizures, and coma. Other features include an acute confusional state, autonomic dysfunction, and retinal ischemia. In this case series, we describe three patients with fat embolism syndrome who presented with atypical symptoms and signs and with unusual neuroimaging findings. Cerebral fat embolism may occur without any respiratory or dermatological signs. In these cases, diagnosis is established after excluding other differential diagnoses. Neuroimaging using brain magnetic resonance imaging is of paramount importance in establishing a diagnosis. Aggressive hemodynamic and respiratory support from the beginning and consideration of orthopedic surgical intervention within the first 24 hours after trauma are critical to decreased morbidity and mortality.
脂肪栓塞综合征是一种罕见但令人担忧的、危及生命的临床病症，归因于脂肪栓子进入血液循环。它通常作为长骨骨折和关节重建手术的并发症出现。神经学表现通常在初始损伤后12至72小时出现。这些神经并发症包括脑梗死、脊髓缺血、出血性中风、癫痫发作和昏迷。其他特征包括急性意识模糊状态、自主神经功能障碍和视网膜缺血。在本病例系列中，我们描述了三名脂肪栓塞综合征患者，他们表现出非典型症状和体征以及不寻常的神经影像学表现。脑脂肪栓塞可能在没有任何呼吸或皮肤体征的情况下发生。在这些病例中，排除其他鉴别诊断后才能确立诊断。使用脑磁共振成像的神经影像学检查对于确立诊断至关重要。从一开始就积极进行血流动力学和呼吸支持，并在创伤后的头24小时内考虑进行骨科手术干预，对于降低发病率和死亡率至关重要。
