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MR imaging of the brain in fat embolism syndrome

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Abstract

Fat embolism syndrome (FES) is an uncommon but serious complication of traumatic injury and is frequently diagnostically challenging. In this paper, the authors present four patients who sustained lower extremity long bone injury and who had a normal Glasgow Coma Scale before orthopedic surgical intervention. However, postoperatively, significant neurological deterioration developed in these patients. While cranial computed tomography (CT) obtained immediately after surgery for acutely altered mental status was negative in two of the four patients, brain magnetic resonance imaging (MRI) demonstrated white and gray matter abnormalities accounting for the impaired neurological status in all cases. MRI findings in conjunction with clinical presentation established the diagnosis in all patients. MRI is indicated in any patient with orthopedic injuries who manifests an unexplained acute alteration in mental status, despite a normal head CT.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Maryland Shock-Trauma Center, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA

    Joseph Jen-Sho Chen & Stuart E. Mirvis

  2. University of Illinois College of Medicine at Rockford, Rockford, IL, USA

    James C. Ha

  3. Department of Diagnostic Radiology, University of Maryland Medical Center, 22 S. Greene St., Baltimore, MD, 21201, USA

    Joseph Jen-Sho Chen

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  1. Joseph Jen-Sho Chen
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  2. James C. Ha
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  3. Stuart E. Mirvis
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Correspondence to Joseph Jen-Sho Chen.

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Chen, J.JS., Ha, J.C. & Mirvis, S.E. MR imaging of the brain in fat embolism syndrome. Emerg Radiol 15, 187–192 (2008). https://doi.org/10.1007/s10140-007-0664-3

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  • DOI: https://doi.org/10.1007/s10140-007-0664-3

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