醫學筆記匯整 ED Notes

21 歲男性機車車禍
右大腿股骨骨折
沒有其他外傷, 意識清醒滿分
隔天早上要開刀了卻突然意識變差叫不醒
變成 E1V2M3
立刻做了不打顯影劑的腦部電腦斷層
沒有出血或明顯異常

後續會診神經內科做了 Brain MRI
報告 :  
DWI : star-field pattern, bilateral diffuse tiny lesions with hyperintensity on DWI
and hypointensity on ADC were noted at bilateral cerebral hemisphere deep white matters, cortical/subcortical regions, deep cerebral gray matters,
and bilateral cerebellar hemispheres, consistent with fat embolic infarction.

長骨骨折後發生少見的脂肪栓塞
Classic triad of respiratory manifestations (95 %), cerebral effects (60 %) and petechiae (33 %)
治療上也只能 Supportive care
簡單看了幾篇 case report
大多預後都說 cerebral dysfunction associated with CFE is reversible 預後有進步的空間