Bouaggad A, Harti A, Elmouknia M, Bouderka M A, Barrou H, Abassi O, Benaguida M
Service d'Anesthésie-Réanimation, CHU Ibn Rochd, Casablanca, Maroc.
Cah Anesthesiol. 1995;43(5):441-3.
Neurologic manifestations are usual and variable during post-traumatic fat embolism. The pathogenesis of these lesions continues to be a source of considerable controversy. Thirteen cases of post-traumatic fat embolism with neurologic signs were treated in a surgical intensive care unit. All patients had impaired consciousness. Focal neurologic disorders were reported in 5 cases [hemiplegia (2), tetraplegia (2), aphasia (1)]. The aspects on brain CT scan seemed to be related to ischemic lesions (1 case), appeared normal in ten cases, or revealed post-traumatic hemorrhagic lesions (2 cases). The outcome at 2-4 weeks was spontaneously good, with complete resolution, without neurologic sequellae, in 11/13 patients. Two deaths were related to brain trauma severity (one case) and nosocomial pneumonia (one case).
创伤后脂肪栓塞期间神经学表现较为常见且多样。这些病变的发病机制一直是相当大争议的来源。13例伴有神经学体征的创伤后脂肪栓塞患者在外科重症监护病房接受了治疗。所有患者均有意识障碍。5例报告有局灶性神经功能障碍[偏瘫(2例)、四肢瘫(2例)、失语(1例)]。脑部CT扫描结果似乎与缺血性病变有关(1例),10例结果正常,或显示创伤后出血性病变(2例)。2至4周时,13例患者中有11例结局自发良好,完全恢复,无神经后遗症。2例死亡分别与脑外伤严重程度(1例)和医院获得性肺炎(1例)有关。