Fat embolism following traumatic injury with cerebral embolism and stroke in the presence of a patent foramen ovale

Abstract

Fat embolism syndrome (FES) most commonly occurs 24-48 hours following trauma or orthopedic surgery. The signs and symptoms of FES are often difficult to identify or may be attributed to the primary event or a comorbid condition. Clinical manifestations vary depending on the clinical scenario, generally including hypoxemia, respiratory insufficiency, a petechial rash, and fever. We report a 13-year-old adolescent who presented with multiple end-organ effects including an embolic stroke in the presence of a patent foramen ovale related to FES following traumatic injury and orthopedic surgery. The proposed pathophysiological mechanisms and etiology of FES are reviewed, diagnostic criteria and work-up presented, and therapeutic interventions discussed.

Keywords

• fat embolism
• fat embolism syndrome
• trauma
• patent fo- ramen ovale