Cerebral Fat Embolism
•Associated with displaced long-bone fractures of the lower extremities (0.5–3.5% of cases)•Right-to-left cardiac shunt is not required for cerebral embolism to occur .
Fat emboli are deformable and can penetrate capillaries. The narrow capillary lumen causes transient stasis of fat emboli. Hence, systemic and pulmonary vascular occlusion is temporary •Cerebral Infarcts may range from a few millimeters to 4 cm in diameter
•Clinical triad -Hypoxia, deteriorating mental status, and petechiae •Neurological symptoms are variable and the clinical diagnosis is difficult. •value of diffusion-weighted MRI of the brain for early diagnosis of fat embolism syndrome
•Diffusion-weighted scans reveal lesions as bright spots on a dark background ("starfield" pattern).
•Their number correlates with the Glasgow Coma Scale.
•Gradient-echo images show little evidence of hemorrhage, which, along with the clinical history, differentiates this entity fromdiffuse axonal injury
•Likelihood of infarction and hemorrhage depends on the size of the fat globules, which depends on the presence or absence of a cardiac shunt and the overall embolism load.
•Lesions gradually disappear within a few weeks to a few months.
•Chronic sequela of CFE is extensive demyelination of the white matter
•Associated with displaced long-bone fractures of the lower extremities (0.5–3.5% of cases)•Right-to-left cardiac shunt is not required for cerebral embolism to occur .
Fat emboli are deformable and can penetrate capillaries. The narrow capillary lumen causes transient stasis of fat emboli. Hence, systemic and pulmonary vascular occlusion is temporary •Cerebral Infarcts may range from a few millimeters to 4 cm in diameter
•Clinical triad -Hypoxia, deteriorating mental status, and petechiae •Neurological symptoms are variable and the clinical diagnosis is difficult. •value of diffusion-weighted MRI of the brain for early diagnosis of fat embolism syndrome
•Diffusion-weighted scans reveal lesions as bright spots on a dark background ("starfield" pattern).
•Their number correlates with the Glasgow Coma Scale.
•Gradient-echo images show little evidence of hemorrhage, which, along with the clinical history, differentiates this entity fromdiffuse axonal injury
•Likelihood of infarction and hemorrhage depends on the size of the fat globules, which depends on the presence or absence of a cardiac shunt and the overall embolism load.
•Lesions gradually disappear within a few weeks to a few months.
•Chronic sequela of CFE is extensive demyelination of the white matter