[Fatal course after osteosynthesis in a 18-year-old male].
A previously healthy patient became comatose 8 h after osteosynthesis of a fractured femur and humerus. After an initially normal cranial computed tomography, extended lesions were found 10 h later in the control scan as an indication of an embolization in the basilar artery. After neurosurgeons assessed the situation to be unfavorable, no other interventions were conducted and 6 days later brain death was confirmed. During the subsequent heart transplantation the suspicion of a patent foramen ovale as the reason for the paradoxical cerebral embolization was confirmed. This tragic course raises the question whether a patent foramen ovale should be excluded or closed by interventional measures in similar situations.
Dinkel
M
M
Fachbereich Anästhesie, Herz- und Gefässklinik GmbH, Bad Neustadt/Saale, Germany. caan@herzchirurgie.de
Glaser
K
K
von Hoch
F
F
D000293:Adolescent; D000758:Anesthesia; D001488:Basilar Artery; D004617:Embolism / Q000209:etiology; D017809:Fatal Outcome; D005264:Femoral Fractures / Q000601:surgery*; D054092:Foramen Ovale, Patent / Q000150:complications / Q000473:pathology; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D016027:Heart Transplantation; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D014019:Tissue Donors; D014057:Tomography, X-Ray Computed