Kimura Seigo, Yagi Ryokichi, Kishi Fumihisa, Ogawa Daiji, Yamada Keiichi, Taniguchi Hirokatsu, Wanibuchi Masahiko
Department of Neurosurgery, Kouzenkai Yagi Neurosurgical Hospital, Osaka, JPN.
Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, JPN.
Cureus. 2023 Mar 8;15(3):e35911. doi: 10.7759/cureus.35911. eCollection 2023 Mar.
Fulminant fat embolism syndrome (FES) occurring within 1 h after trauma is extremely rare. We report a case of fulminant FES that developed hyperacute nature after a traumatic injury. A 66-year-old woman was injured when she fell approximately 1.5 m down the stairs. She was rushed to our hospital. One minute after arrival, which was 49 min after the injury, her consciousness and respiratory status deteriorated. Thoracoabdominal and pelvic computed tomography revealed preexisting interstitial pneumonia, a left femoral neck fracture, and a left sacral fracture. Head magnetic resonance imaging (diffusion-weighted imaging) showed diffuse high-signal areas and susceptibility-weighted imaging showed diffuse small perivascular of perivascular hemorrhages. She was diagnosed with fulminant FES. After conservative treatment, she was transferred to a rehabilitation hospital with a Glasgow Coma Scale (GCS) of 8 and a modified Rankin Scale of 5 on Day 45. The possibility of fulminant FES should be considered a cause of early impaired consciousness after a fracture.
创伤后1小时内发生的暴发性脂肪栓塞综合征（FES）极为罕见。我们报告一例创伤后迅速发展为超急性暴发性FES的病例。一名66岁女性从约1.5米高的楼梯上摔下受伤。她被紧急送往我院。受伤49分钟后到达我院，1分钟后，她的意识和呼吸状况恶化。胸腹部及骨盆计算机断层扫描显示既往存在间质性肺炎、左侧股骨颈骨折和左侧骶骨骨折。头部磁共振成像（弥散加权成像）显示弥漫性高信号区，磁敏感加权成像显示弥漫性小血管周围出血。她被诊断为暴发性FES。经过保守治疗，第45天时她被转至康复医院，格拉斯哥昏迷量表（GCS）评分为8分，改良Rankin量表评分为5分。暴发性FES应被视为骨折后早期意识障碍的一个原因。
