• Journal of Trauma and Injury
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• v.34 no.2
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• pp.126-129
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• 2021

Fat embolism syndrome is a rare, but serious condition that occurs in patients with fractures of the long bones or who undergo orthopedic surgery. The main clinical features of fat embolism syndrome are an altered mental status, hypoxia, and petechial rash. Cerebral fat embolism is the most severe manifestation of fat embolism syndrome because it can lead to an altered mental status. The diagnosis of cerebral fat embolism is clinical, but brain magnetic resonance image (MRI) is helpful. There is usually an interval until symptoms, such as an altered mental status, develop after trauma. We report a case of cerebral fat embolism in which the patient's mental status deteriorated several hours after trauma and the initial findings were negative on diffusion-weighted MRI.

• Journal of Chest Surgery
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• v.53 no.1
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• pp.34-37
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• 2020

Cerebral air embolism combined with cardiomyopathy secondary to pulmonary barotrauma is rare. Here, we report an unusual case of cerebral air embolism combined with transient cardiomyopathy secondary to large bulla rupture during a pulmonary function test after lung cancer surgery. The patient experienced loss of consciousness. Computed tomography and magnetic resonance imaging suggested a cerebral air embolism. Electrocardiography showed ST-segment elevation and abnormally high plasma levels of cardiac enzymes. Echocardiography and coronary angiography suggested cardiomyopathy. The patient was discharged with no sequelae.

• Journal of Trauma and Injury
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• v.26 no.2
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• pp.58-62
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• 2013

A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a posttraumatic cerebral fat embolism without pulmonary involvement and review the existing literature.

• YAKHAK HOEJI
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• v.37 no.1
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• pp.84-88
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• 1993

Brovincamine is a selective cerebral vasodilator that was apparently produced via a slow calcium blockade. Brovincamine has been shown to increase ATP production and glucose and oxygen consumption in brain, improving energy metabolism. Also brovincamine inhibited platelet aggregation induced by ADP and collagen in vivo and in vitro via an increase of cAMP concentration, promoting therapeutic effects on cerebral circulatory disorders. So we investigated and represented the clinical effects and safety of brovincamine in patients with cerebral stroke. Thirty patients of cerebral stroke that was older than 2 months, who were 22 cases of cerebral infarction, 6 of cerebral embolism that originated from carebral infarction, 6 of cerebral embolism that originated from cardiac diseases, and 2 of cerebral embolism that originated from cardiac diseases, and 2 of cerebral hemorrhage, were administered of 20 mg of oral brovincamine three times daily for 8 weeks. Improvement rates of each symptom after 8 week administration were 30.8% for subjective symptoms, 76% for psychiatric symptoms and 65.6% for neurologic symptoms. In final global improvement rates, much improvement was 10%, improvement was 23.3% slight improvement is 36.7%, and no change was 30%. So global improvement rate including slight improvement was 70%. As for side effects, there were 3 cases of mild gastrointestinal symptoms, but there were no other subjective side effects and significant fluctuation in laboratory examination. Conclusively throughout the present study, brovincamine is judged to be well tolerated and effective in patients with cerebral stroke.

• Tuberculosis and Respiratory Diseases
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• v.74 no.6
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• pp.286-290
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• 2013

Pigtail catheter drainage is a common procedure for the treatment of pleural effusion and pneumothorax. The most common complications of pigtail catheter insertion are pneumothorax, hemorrhage and chest pains. Cerebral air embolism is rare, but often fatal. In this paper, we report a case of cerebral air embolism in association with the insertion of a pigtail catheter for the drainage of a pleural effusion. A 67-year-old man is being presented with dyspnea, cough and right-side chest pains and was administered antibiotics for the treatment of pneumonia. The pneumonia failed to resolve and a loculated parapneumonic pleural effusion developed. A pigtail catheter was inserted in order to drain the pleural effusion, which resulted in cerebral air embolism. The patient was administered high-flow oxygen therapy and recovered without any neurologic complications.

• Investigative Magnetic Resonance Imaging
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• v.23 no.1
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• pp.70-74
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• 2019

Cerebral air embolism (CAE) is a rare complication of various medical procedures. It manifests with symptoms similar to those of typical acute cerebral infarction, however the treatment is quite different. We present a case of arterial CAE that was associated with a disconnected central venous catheter and appeared as punctate dark signal intensities with aliasing artifacts on the susceptibility-weighted filtered phase magnetic resonance image. The susceptibility-weighted filtered phase image can be helpful for diagnosing CAE and the magnetic resonance imaging reflects the pathophysiology of CAE.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.175-178
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• 2005

Fat embolism syndrome is a collection of respiratory, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of clinical syndrome is low while the embolization of marrow fat appears to be an almost inevitable consequence of long bone fractures. The pathogenesis is a subject of conjecture and controversy. There are two theories which have gained acceptance(mechanical theory, biochemical theory). Onset of symptom is usually within 12 to 72 hours, but may manifest as early as 6 hours to as late as 10 days. The classic triad of fat embolism syndrome involves pulmonary changes, cerebral dysfunction and petechial rash. The cornerstone of treatment is preventing the stress response, hypovolemia and hypoxia and operative stabilization of fractures. Corticosteroid are the only drugs which have repeatedly shown a positive effect on the prevention and treatment of fat embolism syndrome. We report a case of post-traumatic fat embolism syndrome with severe cerebral involvement without respiratory distress. A 55 years old female had a traffic accident. She sustained pelvic bone fracture and both humerus fracture. Approximately 4 hours after the accident, mental status change developed without a focal neurologic deficits. She had no respiratory symptom and sign. Her brain MRI showed multiple cerebral fat embolism lesion. The patients received supportive treatment with corticosteroid, albumin. Her neurologic status stabilized over several days. After orthopedic surgery, she was discharged 62 days after admission.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.207-211
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• 2023

Fat embolism syndrome is a rare but alarming, life-threatening clinical condition attributed to fat emboli entering the circulation. It usually occurs as a complication of long-bone fractures and joint reconstruction surgery. Neurological manifestations usually occur 12 to 72 hours after the initial insult. These neurological complications include cerebral infarction, spinal cord ischemia, hemorrhagic stroke, seizures, and coma. Other features include an acute confusional state, autonomic dysfunction, and retinal ischemia. In this case series, we describe three patients with fat embolism syndrome who presented with atypical symptoms and signs and with unusual neuroimaging findings. Cerebral fat embolism may occur without any respiratory or dermatological signs. In these cases, diagnosis was established after excluding other differential diagnoses. Neuroimaging using brain magnetic resonance imaging is of paramount importance in establishing a diagnosis. Aggressive hemodynamic and respiratory support from the beginning and consideration of orthopedic surgical intervention within the first 24 hours after trauma are critical to decreased morbidity and mortality.

• Journal of Chest Surgery
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• v.4 no.1
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• pp.11-24
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• 1971

Eighty-four cases of mitral commissurotomy were done in this department between October 1958 and September 1970. Therc wcre 54 males and 30 females. Six cases were under the age of 20 years. Prcoperativc embolization occurred in 9. 5% of the cases. consisting of 8. 3% cerebral and 1.2% peripheral embolization. Intraoperative and postoperative cmbolization occurred in 4.7% of the cases, with 1. 2% cerebral and 3.5% peripheral embolism. Two out of three postopeative embolism cases expired, one of which was caused by septic cerebral embolism due to valve vegetation nnd the other by mesenteric embolism. Atrial fibrillation was 1loted ill 43% of the case. Seventy closed mitral commissurotomy was done by left appendegeal approach with finger fracture method or Bailey's guillotine valvotome. Fourteen open mitral commissurotomy cases were done either by right side approach or median sternotomy, three of which were reoperation cases after blind mitral commissurotomy. One out of 14 cases were operated on with open mitral commissurotomy and concomitant open aortic valve bicuspidalization, This case expired due to severe serum hepatitis ten days after operation. Thirty-two per cent of valve calcification was noted during operation and one of which had marked vegetation on the valve cusps too. Operative mortality was 1.4% in blind mitral commissurotomy and 14% in open mitral commissurotomy. Over-all mortality in the entire series was 3.5%. One case among the blind commissurotomy cases expired during operation due to left inferior pulmonary vein laceration and death was caused in two open mitral commissurotomy cases by coronary artery airembolism. Three hospital death occurred in blind operation group, one due to coronary embolism, and two by hepatic failures. Three hospital death among open heart surgery cases were caused by hepatic failure in two and cerebral embolism in one cases. ln most of the survivors improved functional capacity and exercise lolerance were noted.

• Biomedical Science Letters
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• v.10 no.2
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• pp.115-120
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• 2004

To investigate the correlation between the magnetic resonance imaging (MRI) of cerebral fat embolism that is induced by injecting oleic acid into 10 cats, and a pathologic diagnosis. Using a microcatheter, 30 ${mu}ell$ of oleic acid was injected into the internal carotid artery of 10 cats. MR T2-weighted image (T2WI), diffusion-weighted image (DWI) and Gadolinium-enhanced T1-weighted image (Gd-enhanced T1WI) were obtained after 30 minutes and 2 hours of embolization. After 30 minutes of the embolization, lesions of very high signal intensity were detected by T2WI in 6 cats, and of slightly high signal intensity in 2 cats; in the remaining 2 cats, signal intensity was normal. DWI showed lesions of very high intensity in 9 cats and of slightly high intensity in one cat. According to the findings of light microscopic examination, infarcted lesions mainly involved the gray matter, but also some white matter. A magnetic resonance imaging diagnosis for cerebral fat embolism that was induced by oleic acid through the internal carotid artery in cats showed high signal intensity on the T2WI and the DWI within an initial 2 hours, and with a well enhancement on the Gd-enhanced T1WI. Considering cellular edema, cerebrovascular injury and extracellular space widening, we assumed pathologically that cytotoxic and vasogenic edema exists at the same time.