The intersection of cerebral fat embolism syndrome and traumatic brain injury: a literature review and case series. (2nd July 2020)

• Record Type: Journal Article
• Authors: Davis, Taron; Weintraub, Alan; Makley, Michael; Spier, Eric; Forster, Jeri
• Is Part Of: Brain injury. Volume 34:Number 8(2020)
• Page Start: 1127
• Page End: 1134
• Publication Date: 2020-07-02
• Subjects: Cerebral fat embolism syndrome -- fat embolism syndrome -- diffuse axonal injury -- magnetic resonance imaging -- fractures -- intensive care -- recovery -- traumatic brain injury -- outcomes -- orthopedics -- focal cortical contusion -- function; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2020.1776898
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective: To review the historical, clinical, radiographic, and outcome characteristics of individuals diagnosed with an acquired brain injury (ABI) due to cerebral fat embolism syndrome (CFES) with and without features of traumatic brain injury (TBI) Methods: A retrospective chart review of individuals with the diagnosis of CFES admitted to an ABI rehabilitation program. Cases were divided into two cohorts 1) individuals with evidence of classic features of CFES alone, and 2) individuals with evidence of CFES in conjunction with features of TBI. Results: 14 individuals were identified, seven individuals with diagnosis of CFES alone, and seven with CFES and TBI. Median initial GCS was 15 for the isolated CFES cohort and 8 for the dual diagnosis cohort (p =.006). There were clear qualitative differences in MRI findings with characteristic patterns between the two groups. Conclusion: The diagnosis of CFES is an important consideration for individuals who have new neurologic impairment following a trauma, especially in cases where initial GCS was high. MRI has an important role in differentiating lesions of CFES from TBI and should be utilized for prognostication and management decisions. Individuals with neurologic injury secondary to CFES had good functional recovery outcomes as measured by Glasgow Outcome Scale.