A 16-year-old girl hit her left leg against a tree while riding horseback. At admission to a community hospital, a tibial wedge fracture was diagnosed and treated conservatively (Figure, A). Twenty hours after the trauma, the patient became nauseous and vomited. Three hours later, automotor seizures occurred, and she became comatose. Endotracheal intubation was performed to protect the airway (Glasgow-Coma Scale 7/15). A diagnostic workup including drug screening, lumbar puncture, standard laboratory testing, 2 cerebral computed tomographic scans, and cerebral computed tomographic angiography revealed no pathologic findings.
Hüfner K, Holtmannspötter M, Bürkle H, Schaller UC, Ebert AD, Trentzsch H, Pfister H, Lücking CB. Fat Embolism Syndrome as a Neurologic Emergency. Arch Neurol. 2008;65(8):1124-1125. doi:10.1001/archneur.65.8.1124