Fat embolism syndrome in a patient that sustained a femoral neck fracture: A case report

L. A.S.den Otter*, B. Vermin, M. Goeijenbier

*Corresponding author for this work

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Abstract

Background: We present a case of a patient with a femoral neck fracture that shows neurological impairment and respiratory distress 1 day after trauma, caused by the Fat Embolism Syndrome with the presence of Cerebral Fat Embolisms. Case summary: A 75 year old female remained unresponsive after a hemi arthroplasty was performed because of a 1 day old femoral neck fracture. She rapidly developed respiratory insufficiency and an obstructive shock with right ventricle dilatation on transthoracic echocardiography. The diffusion-weighted MRI brain images showed the “Starfield” pattern, a radiologic phenomenon typical for FES. During 3 weeks of ICU admission the neurologic state slowly ameliorated. Conclusion: The rare FES is a clinical diagnosis with mainly respiratory, neurologic and dermatologic symptoms in the setting of a trauma patient. Fat embolisms are able to reach the brain without the presence of a patent foramen ovale to cause neurological symptoms. Diagnosing FES remains challenging but the distinctive “Starfield” pattern on MRI scans is promising.

Original languageEnglish
Article number1058824
JournalFrontiers in Medicine
Volume9
DOIs
Publication statusPublished - 8 Dec 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Otter, Vermin and Goeijenbier.

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