Spinal cord infarction as a rare complication of fat embolism syndrome following bilateral intramedullary nailing of femur fractures.
Fat embolism syndrome (FES) is a rare and potentially fatal complication occurring most often after long bone or pelvic fractures and orthopaedic procedures. It can consist of pulmonary, central nervous system and cutaneous manifestations. The exact pathophysiology of emboli reaching the arterial circulation is poorly understood.1 It is suggested that this may occur by either 'paradoxical' embolism or microembolism.2 3 Its true incidence is unknown but increases in the presence of multiple closed fractures. It can be a diagnostic dilemma for clinicians and if suspected diffusion-weighted MRI is the modality of choice for the investigation of the central nervous system.4 We present the case of a 22-year-old man who developed multifocal cerebral infarcts, a right-sided cerebellar infarct and an infarct in the anterior cord bilaterally at the level of C5-C6 as a result of FES.
Department of Anaesthesia and Intensive Care Medicine, University Hospital Limerick, Limerick, Ireland.
RoseMarie
R
Kearsley
University Hospital Limerick, Limerick, Ireland.
John
J
Galbraith
Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland.
David
http://orcid.org/0000-0002-4343-8016
D
Dalton
Department of Anaesthesia and Intensive Care Medicine, University Hospital Limerick, Limerick, Ireland.
Catherine
C
Motherway
D002574:Cervical Vertebrae; D004620:Embolism, Fat / Q000150:complications*; D005264:Femoral Fractures / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging; D055815:Young Adult