Clinical characteristics of cerebral fat embolism syndrome and its differential analysis from diffuse axonal injury
Wei Guizhi
Liang Xiaoli
Wang Xianqi
Fan Feifei
Wang Yutong
Abstract：Objective To explore and analyze the clinical characteristics and diagnostic difficulties of cere-bral fat embolism syndrome(FES).Methods This retrospective analysis was conducted on 24 patients with cere-bral FES or diffuse axonal injuries(DAI)admitted to our department(rescue room and ICU)from Jan.1st,2016 to Jan.1st,2022,including 21 males and 3 females aged 14-56(mean 33.3)years.The injury causes were falls from height in 4 cases,road traffic accidents in 19,and crash by heavy objects in 1.According to the final diagnosis,patients were divided into cerebral FES group(11 cases)and DAI group(13 cases),and their clinical characteris-tics were analyzed.The mental status,hemoglobin,PLT,creatine kinase,IL-6 and D-dimer,and head MRI results within 24 h after injury were compared between the two groups.Results The cerebral FES group revealed 63.6%of patients with simple lower limb fractures,while the DAI group revealed 61.5%of patients with multiple injuries combined with cranial trauma.The average onset of consciousness disorders was(15.82±9.70)h for cerebral FES,while only(0.78±1.99)h for DAI.The hemoglobin,PLT,creatine kinase,and IL-6 level at the first visit after in-jury revealed no statistically significant difference between the two groups(all P>0.05),while the D-dimer level was much higher in the cerebral FES group(P<0.05).The cranial MRI within 24 h after injury was meaningful:the cerebral FES is often manifested as symmetrical bilateral cerebral hemispheres on DWI and T2,while DAI as a-symmetrical;moreover,the SWI phase was more significant.In our series,all the cerebral FES cases showed nega-tive results while the detection rate of DAI reached as high as 92.31%.Conclusion Cerebral FES and DAI have different clinical characteristics in terms of injury site and onset time of consciousness disorder after injury.Patients with cerebral FES have higher D-dimer levels than those with DAI,which can be used as a reference for differential diagnosis.More importantly,head MRI can effectively distinguish the differences between cerebral FES and DAI,and is the most meaningful exam for the diagnosis of cerebral FES in clinical practice.
Keywords：Cerebral fat embolism syndromeDiffuse axonal injuryClinical characteristicss
Publication Date：2025-01-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 60-65 )