交通事故致长骨骨折并发脑脂肪栓塞综合征1例

Xingwu Chen, Jianfeng Fang, M. Deng, Ting Jiang, Feng Luo
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引用次数: 1

摘要

脑脂肪栓塞综合征(CFES)是一种罕见但严重的长骨骨折并发症。我们报告了一名19岁的男性患者,他在交通事故受伤后因多肢长骨骨折而患上了CFES。他在受伤后24小时内逐渐陷入昏迷。动脉血气分析正常。胸部计算机断层扫描(CT)显示右侧胸膜腔内有少量气体。尽管最初的脑CT检查结果没有明显的颅内异常,但观察到典型的星形场模式和散在灶的脑磁共振成像(MRI)结果。MRI的T2加权成像和扩散加权成像均显示双侧大脑半球白质、灰质、基底节、胼胝体和丘脑有多处分散性病变,表明在敏感性加权成像序列上没有微出血的急性梗死。根据以上发现,本病例诊断为脑脂肪栓塞综合征。尽管患者在重症监护室接受了全面支持治疗,但他仍然昏迷,住院7天后出院。
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Cerebral fat embolism syndrome after long bone fracture due to traffic accident: a case report
Cerebral fat embolism syndrome (CFES) is an uncommon but serious complication of long bone fracture. We reported a 19-year-old male patient who sustained CFES due to multiple limbs long bone fractures after a traffic accident injury. He gradually developed into coma within 24 h after his injury. The arterial blood gas analyses were normal. There was a small amount of gas in the right pleural cavity on the thoracic computed tomography (CT). Although there were no remarkable intracranial abnormalities on the initial brain CT findings, the typical brain magnetic resonance imaging (MRI) findings of the starfield pattern and scattered foci were observed. Both T2-weighted imaging and diffusion weighted imaging of MRI indicated multiple scattered lesions in the bilateral cerebrum hemisphere white matter, grey matter, basal ganglia, corpus callosum and thalamus indicative of acute infarcts without microbleeding on the susceptibilityweighted imaging sequences. With the above findings, the diagnosis of the case was cerebral fat embolism syndrome. Although the patient was treated with comprehensive support in the intensive care unit, he remained unconscious and was discharged after 7 days of hospitalization.
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