{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:09:29Z","timestamp":1761156569257,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,16]]},"abstract":"<jats:p>Fat embolism syndrome (FES) is a rare multisystem, clinical syndrome occurring in 0.9%\u20132.2% of long-bone fractures. The severity of FES can vary from subclinical with mild respiratory changes and haematological aberrations to a fulminant state characterised by sudden onset of severe respiratory and neurological impairment. Here we present two patients with cerebral FES secondary to femur fracture. Both patients exhibited profound neurological impairment with varied outcomes. Our cases highlight the importance of a high clinical suspicion of FES in patients with long-bone fractures and neurological deterioration. We recommend early plate osteosynthesis to prevent additional emboli in patients with FES and situational placement of intracranial pressure monitoring. Finally, cerebral FES has low mortality even in a patient with tentorial herniation and fixed, dilated pupils.<\/jats:p>","DOI":"10.1136\/bcr-2018-225261","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T02:35:11Z","timestamp":1539052511000},"page":"bcr-2018-225261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cerebral fat embolism syndrome (FES): similar cases with different outcomes"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2370-4804","authenticated-orcid":false,"given":"Alexis","family":"Jorgensen","sequence":"first","affiliation":[{"name":"Howard Hughes Medical Institute, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azhar","family":"Bashir","sequence":"additional","affiliation":[{"name":"Howard Hughes Medical Institute, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jibanananda","family":"Satpathy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Virginia Commonwealth University, Glen Allen, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,10,8]]},"reference":[{"key":"2025082802110799000_2018.oct08_1.bcr-2018-225261.1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/1751143717718664","article-title":"Neurological effects of fat embolism syndrome: a case report","volume":"18","author":"Shacklock","year":"2017","journal-title":"J Intensive Care Soc"},{"key":"2025082802110799000_2018.oct08_1.bcr-2018-225261.2","doi-asserted-by":"crossref","unstructured":"Godoy DA , Di Napoli M , Rabinstein AA . 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