Open AccessUnexpected good outcome in severe cerebral fat embolism syndrome
Author(s) -
Hermann Bertrand,
Brisson Hélène,
Langeron Olivier,
Pyatigorskaya Nadya,
Paquereau Julie,
Robert Hélène,
Stender Johan,
Habert MarieOdile,
Naccache Lionel,
Monsel Antoine
Publication year - 2018
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.596
Subject(s) - medicine , magnetic resonance imaging , multimodal therapy , presentation (obstetrics) , functional magnetic resonance imaging , fat embolism syndrome , persistent vegetative state , consciousness , electroencephalography , neuroimaging , fat embolism , outcome (game theory) , intensive care medicine , physical medicine and rehabilitation , cardiology , radiology , neuroscience , minimally conscious state , psychiatry , biology , mathematics , mathematical economics
Abstract In this case study, we report the longitudinal and multimodal follow‐up of a catastrophic initial presentation of cerebral fat embolism syndrome. We show that despite the initial severity, the cognitive outcome was ultimately very good but with a highly nonlinear time‐course and prolonged loss of consciousness (more than 2 months). Repeated clinical assessments and brain‐imaging techniques (electroencephalography, event‐related potential, 18 ‐Fluoro‐Deoxy‐Glucose‐ PET and magnetic resonance imaging) allowed us to monitor and anticipate this dynamic, providing relevant information to guide decision making in front of withdrawal of life‐sustaining therapy discussions. This case illustrates the value of multimodal functional imaging in devastating brain injuries.