심장의 우-좌 단락 없이 발생한 뇌 지방색전증후군 1예
A Case of Cerebral Fat Embolic Syndrome without Right to Left Cardiac Shunt
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We report a case of fat embolic syndrome (FES) without right-to-left cardiac shunt and intact pulmonary circulation. A 26-year-old man was admitted with multiple long bone fractures by a motor vehicle accident. The patient’s consciousness suddenly deteriorated to semicomatous status after 9 hours from the accident. Small and scattered lesions were observed in the bilateral thalami, basal ganglia and hemispheres on initial diffusion and T2- weighted MRI. Neurologic conditions of the patient were nearly recovered to previous normal condition after 4 weeks and the multiple cerebral lesions disappeared completely on follow up MRI. No evidence of right-to-left shunt was detected on initial and follow up transcranial Doppler and transoesophageal echocardiography. Direct passage of deformable fat emboli through the pulmonary capillary system could be a possible mechanism of FES. (Korean Journal of Stroke 2005;7(2): 244~246)
Abstract
We report a case of fat embolic syndrome (FES) without right-to-left cardiac shunt and intact pulmonary circulation. A 26-year-old man was admitted with multiple long bone fractures by a motor vehicle accident. The patient’s consciousness suddenly deteriorated to semicomatous status after 9 hours from the accident. Small and scattered lesions were observed in the bilateral thalami, basal ganglia and hemispheres on initial diffusion and T2- weighted MRI. Neurologic conditions of the patient were nearly recovered to previous normal condition after 4 weeks and the multiple cerebral lesions disappeared completely on follow up MRI. No evidence of right-to-left shunt was detected on initial and follow up transcranial Doppler and transoesophageal echocardiography. Direct passage of deformable fat emboli through the pulmonary capillary system could be a possible mechanism of FES. (Korean Journal of Stroke 2005;7(2): 244~246)