Encephalopathy and MRI abnormalities in fat embolism syndrome: a case report.

BACKGROUND: Fat embolization and fat embolism syndrome are poorly understood complications of skeletal trauma. Fat embolism syndrome is a clinical diagnosis, and patients typically present with a classic triad of petechial rash, pulmonary distress, and neurologic dysfunction. The incomplete form of the syndrome (i.e., cerebral fat embolism) is a more challenging clinical diagnosis in which brain magnetic resonance imaging may be a valuable tool. Fat embolism syndrome can be a life-threatening condition, but the latent form that occurs 24 to 72 hours after the trauma is frequently described as a self-limiting condition. CASE REPORT: In this report, we present the case of a 32-year-old man with fat embolism syndrome and a prolonged coma with persistent cerebral dysfunction. Brain magnetic resonance imaging revealed multiple white and grey matter lesions suggestive of vasogenic edema and punctuate hemorrhage, consistent with a diagnosis of cerebral fat emboli. CONCLUSIONS: The pathogenesis and treatment options of fat embolism syndrome are reviewed based on available literature, and the usefulness of brain magnetic resonance imaging is discussed.