title: [Coma after lucid interval--severe secondary alteration of consciousness following multiple trauma].
abstract: A 71-year-old man sustains multiple fractures in an accident; after a lucid interval he deteriorates neurologically and becomes comatose. Intracranial hemorrhage, status epilepticus, adverse drug reactions, toxic-metabolic, ischemic or infectious causes are subsequently ruled out. Development of petechiae and thrombopenia raises the possibility of fat embolism syndrome, which is confirmed in a MRI of the head 72 hours after the accident. We discuss current aetiologic concepts as well as diagnosis and clinical course of the cerebral fat embolism syndrome.
authors.affiliation: Medizinische Klinik, Regionalspital Emmental, Burgdorf. j.c.richter_md@hotmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Richter
authors.forename: M M
authors.initials: MM
authors.lastname: Stansiak
authors.forename: P
authors.initials: P
authors.lastname: Freitag
mesh_terms: D000368:Aged; D020207:Coma, Post-Head Injury / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D004620:Embolism, Fat / Q000175:diagnosis*; D015600:Glasgow Coma Scale; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis; D020766:Intracranial Embolism / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed