Vincent Lopez Rowe, MD is a member of the following medical societies: American College of Surgeons, American Surgical Association, Pacific Coast Surgical Association, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Western Vascular SocietyDisclosure: Nothing to disclose. 2016 Apr. Fat embolism syndrome with cerebral fat embolism, rarely observed at our neurology department, is often associated with long bone fractures. Metting Z, Rödiger LA, Regtien JG, van der Naalt J. Originally published in Journal of Orthopaedics (http://www.jortho.org/2008/5/4/e8/). Epub 2013 Aug 27. Fat embolism syndrome occurs when embolic fat macroglobules pass into the small vessels of the lung and other sites, producing endothelial damage and resulting respiratory failure (acute respiratory distress syndrome (ARDS-like) picture), cerebral dysfunction and a petechial rash [2, 3].It can be difficult to diagnose. The fat embolism syndrome (FES) is a complication of long bone fractures, orthopedic surgery, and traumatic lesions of the viscera and subcutaneous tissue, including burns. Kellogg RG, Fontes RB, Lopes DK; Massive cerebral involvement in fat embolism syndrome and intracranial pressure management. 2014 Jan. 28(1):23-30. This guidance is changing frequently. Clinical Imaging is a PubMed-indexed, peer-reviewed monthly journal publishing innovative diagnostic radiology research, reviews, editorials and more. Kellogg RG, Fontes RB, Lopes DK. However, neurologic symptoms are often transient and can vary from focal deficits to diffuse encephalopathy [1, 4]. Other symptoms may include fever and decreased urine output. 153(5):1691-6. Crit Care Med. For details see our conditions. Try our Symptom Checker Got any other symptoms? symptoms of cerebral FE are usually transient and entirely reversible, the condition is usually misdiagnosed and fatal if the treatment is delayed. There is a fulminant form which presents as acute cor pulmonale, respiratory failure and/or embolic phenomena leading to death within a few hours of injury. Shier MR, Wilson RF, James RE, Riddle J, Mammen EF, Pedersen HE. 113:93-100. Respir Med. Blood flow to the brain must be restored as quickly as possible. Report of a case with brief review of the literature. [2]. Injury. Pulmonary injury caused by free fatty acid: evaluation of steroid and albumin therapy. The clinical triad of fat embolism syndrome consists of mental confusion, respiratory distress, and petechiae. Corticosteroids do not inhibit acute pulmonary response to fat embolism. 2009 Sep. 111(7):597-600. . Petechial rash - commonly over the upper anterior part of the trunk, arm and neck, buccal mucosa and conjunctivae. eCollection 2018. Rajan Gupta, MD, FACS, FCCP Associate Professor of Surgery, Chief, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School Cerebral fat embolism usually consists of multiple microembolic infarctions, with classic starfield pattern on diffusion-weighted MR imaging [4]. Fulde GW, Harrison P. Fat embolism--a review. As a young child, Alexandria, now age 17, endured near-constant feelings of exhaustion and general sickness, which turned into severe pain at night. J Trauma. On the other hand, maintenance of intravascular volume is important because shock can exacerbate the lung injury caused by FES[8]. Cerebral fat embolism (CFE) syndrome is rarely observed in clinical practice. Transcranial doppler detection of fat emboli. Fat embolism syndrome: State-of-the-art review focused on pulmonary imaging findings. 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