Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report

ABSTRACT We here describe a rare case of a 26‐year‐old male patient, presenting to our hospital after a motorcycle–car accident for the surgical management of long‐bone fractures to the tibia and femur and shoulder dislocation and undergoing orthopedic surgery, who postoperatively developed seizure,...

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Main Authors: Mariachiara Ippolito, Vincenzo Benenati, Valentina Gambino, Maria Lapi, Dario Nicosia, Alessandro Pace, Gabriele Presti, Fiammetta Ronga, Noemi Spina, Marco Tutone, Rosaria Vanella, Antonino Federico, Antonino Giarratano, Andrea Cortegiani
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.9671
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author Mariachiara Ippolito
Vincenzo Benenati
Valentina Gambino
Maria Lapi
Dario Nicosia
Alessandro Pace
Gabriele Presti
Fiammetta Ronga
Noemi Spina
Marco Tutone
Rosaria Vanella
Antonino Federico
Antonino Giarratano
Andrea Cortegiani
author_facet Mariachiara Ippolito
Vincenzo Benenati
Valentina Gambino
Maria Lapi
Dario Nicosia
Alessandro Pace
Gabriele Presti
Fiammetta Ronga
Noemi Spina
Marco Tutone
Rosaria Vanella
Antonino Federico
Antonino Giarratano
Andrea Cortegiani
author_sort Mariachiara Ippolito
collection DOAJ
description ABSTRACT We here describe a rare case of a 26‐year‐old male patient, presenting to our hospital after a motorcycle–car accident for the surgical management of long‐bone fractures to the tibia and femur and shoulder dislocation and undergoing orthopedic surgery, who postoperatively developed seizure, coma, and respiratory failure due to a cerebral fat embolism. After some hours after the surgery, a loss of consciousness was described by caregivers, and the ICU team was alerted, and the patient was admitted to ICU. Intracranial hemorrhage and stroke were subsequently excluded and, finally, a whole‐body computed tomography angiography scan and head magnetic resonance imaging showed lesions consistent with cerebral fat embolism. Patent foramen ovale was then suspected by contrasted echocardiography. An early diagnosis helped to choose the correct management, with early tracheostomy, and to correctly interpret and manage hemodynamic dysregulations. Overall, the care provided lead to positive long‐term outcomes, as the patient was discharged alive and successfully completed neurological rehabilitation, regaining many functional abilities. The initial management, diagnostic pathway, and ICU management are here described.
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spelling doaj-art-252cf9573c7c4506b905bf81afb5241d2025-08-20T02:35:30ZengWileyClinical Case Reports2050-09042024-12-011212n/an/a10.1002/ccr3.9671Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case ReportMariachiara Ippolito0Vincenzo Benenati1Valentina Gambino2Maria Lapi3Dario Nicosia4Alessandro Pace5Gabriele Presti6Fiammetta Ronga7Noemi Spina8Marco Tutone9Rosaria Vanella10Antonino Federico11Antonino Giarratano12Andrea Cortegiani13Department of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyDepartment of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone Palermo ItalyABSTRACT We here describe a rare case of a 26‐year‐old male patient, presenting to our hospital after a motorcycle–car accident for the surgical management of long‐bone fractures to the tibia and femur and shoulder dislocation and undergoing orthopedic surgery, who postoperatively developed seizure, coma, and respiratory failure due to a cerebral fat embolism. After some hours after the surgery, a loss of consciousness was described by caregivers, and the ICU team was alerted, and the patient was admitted to ICU. Intracranial hemorrhage and stroke were subsequently excluded and, finally, a whole‐body computed tomography angiography scan and head magnetic resonance imaging showed lesions consistent with cerebral fat embolism. Patent foramen ovale was then suspected by contrasted echocardiography. An early diagnosis helped to choose the correct management, with early tracheostomy, and to correctly interpret and manage hemodynamic dysregulations. Overall, the care provided lead to positive long‐term outcomes, as the patient was discharged alive and successfully completed neurological rehabilitation, regaining many functional abilities. The initial management, diagnostic pathway, and ICU management are here described.https://doi.org/10.1002/ccr3.9671case reportfat embolism syndromeintensive care unittrauma
spellingShingle Mariachiara Ippolito
Vincenzo Benenati
Valentina Gambino
Maria Lapi
Dario Nicosia
Alessandro Pace
Gabriele Presti
Fiammetta Ronga
Noemi Spina
Marco Tutone
Rosaria Vanella
Antonino Federico
Antonino Giarratano
Andrea Cortegiani
Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report
Clinical Case Reports
case report
fat embolism syndrome
intensive care unit
trauma
title Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report
title_full Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report
title_fullStr Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report
title_full_unstemmed Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report
title_short Cerebral Fat Embolism After Traumatic Long‐Bone Fracture: A Case Report
title_sort cerebral fat embolism after traumatic long bone fracture a case report
topic case report
fat embolism syndrome
intensive care unit
trauma
url https://doi.org/10.1002/ccr3.9671
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