[Post-traumatic cerebral fat embolism].
A seventeen year old boy sustained pelvic, femoral shaft and malleolar fractures in a road traffic accident. Six hours after admission, the patient became comatose (Glasgow coma score = 7); the coma worsened such that, 24 h later, the coma score was 4. Petechiae were present on the conjunctiva and anterior chest wall. Computed tomography revealed diffuse brain swelling. The diagnosis of cerebral fat embolism was made. There were multiple episodes of severe intracranial hypertension. After 23 days of traction, the femoral fracture was internally fixed. The patient returned home after five months of hospital, with just a few memory and writing problems. Ten months after the accident, magnetic resonance imaging showed a small ventricular dilatation due to subcortical atrophy. Residual ischaemic lesions and demyelination could be seen in the right centrum ovale and temporal lobe. The cerebral lesions contrast with the reversibility of the clinical state.
Thicoïpe
M
M
Service de Réanimation Traumatologique et Post-Chirurgicale, Hôpital Pellegrin, Bordeaux.
André
M
M
Maurette
P
P
Lassie
P
P
Claverie
J P
JP
D000293:Adolescent; D003128:Coma / Q000209:etiology*; D004620:Embolism, Fat / Q000000981:diagnostic imaging / Q000209:etiology*; D005264:Femoral Fractures / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D009104:Multiple Trauma / Q000150:complications*; D010384:Pelvic Bones / Q000293:injuries*; D014057:Tomography, X-Ray Computed
Embolie graisseuse cérébrale post-traumatique.