title: Hyperacute cerebral fat embolism in a patient with femoral shaft fracture.
abstract: Fat embolism syndrome is a potentially fatal complication and occurs most commonly after long bone fracture. In patients who sustained severe trauma, both cerebral fat embolism(CFE) and diffuse axonal injury (DAI) could be the cause of altered consciousness in the absence of marked intracranial lesions in cranial computed tomography. However, distinguishing CFE and DAI can be difficult clinically. Generally, DAI develops immediately after the insult, whereas CFE occurs 48 to 72 hours after the trauma and even after internal fixation for the fractures. Fat embolism syndrome develops within an average of 48.5 hours after long bone fracture [1] but has never been reported to occur in less than 2 hours. Here, we present a patient who developed hyperacute CFE and eventually had poor neurological outcome, in contrast to previous reports stating that CFE usually has a long latent period and favorable outcomes.
authors.affiliation: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
authors.forename: Po-Chuan
authors.initials: PC
authors.lastname: Chen
authors.forename: Chin-Wang
authors.initials: CW
authors.lastname: Hsu
authors.forename: Wen-I
authors.initials: WI
authors.lastname: Liao
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Chen
authors.forename: Cheng-Hsuan
authors.initials: CH
authors.lastname: Ho
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Tsai
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology*; D004620:Embolism, Fat / Q000175:diagnosis / Q000209:etiology*; D004636:Emergency Service, Hospital; D005264:Femoral Fractures / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging