Williams Jordyn D, Gates Jonathan D, Croteau Alfred J
University of Connecticut School of Medicine, 200 Academic Wy, Farmington, CT 06032, USA.
Hartford Healthcare Medical Group, 85 Seymour Street, Suite 415, Hartford, CT 06102, USA.
Trauma Case Rep. 2024 Sep 13;54:101109. doi: 10.1016/j.tcr.2024.101109. eCollection 2024 Dec.
Fat Embolism Syndrome (FES) is a rare clinical phenomenon attributed to fat droplet embolization and subsequent multisystem organ failure, typically following traumatic orthopedic injury. It classically presents with hypoxemia, transient neurologic deficits, and skin changes that appear a day or more after the initial insult. Its exact mechanism remains unclear, although the mechanical obstruction of capillaries or production of toxic intermediaries following fat hydrolysis and extravasation of marrow have been described. Here, we present a new case of cerebral FES with symptom onset within 12 h and brain death within 48 h.
A 22-year-old male with multiple orthopedic fractures developed Fat Embolism Syndrome with neurological and respiratory symptoms within 12 h of presentation.
The patient developed intractable cerebral edema and hypernatremia leading to brain death within 48 h.
Diffuse fat emboli can lead to rapid development of fatal cerebral edema even in the absence of anatomical shunts. MRI is the superior modality to detect FES and should be pursued early in patients with risk factors or clinical signs of neurologic involvement.
脂肪栓塞综合征（FES）是一种罕见的临床现象，通常继发于创伤性骨科损伤，由脂肪滴栓塞及随后的多系统器官衰竭引起。其典型表现为低氧血症、短暂性神经功能缺损以及在初始损伤一天或更长时间后出现的皮肤改变。尽管已经描述了脂肪水解和骨髓外渗后毛细血管的机械性阻塞或有毒中间产物的产生，但确切机制仍不清楚。在此，我们报告一例脑型FES新病例，症状在12小时内出现，48小时内发生脑死亡。
一名22岁男性，多处骨科骨折，在就诊后12小时内出现伴有神经和呼吸症状的脂肪栓塞综合征。
患者出现顽固性脑水肿和高钠血症，48小时内导致脑死亡。
即使没有解剖分流，弥漫性脂肪栓子也可导致致命性脑水肿的快速发展。MRI是检测FES的最佳方式，对于有危险因素或神经系统受累临床体征的患者应尽早进行检查。
