Recovery after Cerebral Fat Embolism

Background: The recovery of cerebral fat embolism (CFE) is continuous and slowly progressive. No current studies evaluate the stages of the recovery. In this paper, we discussed the clinical course of six patients diagnosed with CFE after traumatic bone fractures using a two-stage evaluation. Methods: A total of six patients were retrospectively included between 2010 and 2016. All patients were diagnosed using magnetic resonance imaging (MRI).We divided their recovery into two stages: 1) regaining of consciousness and 2) recovery of cognitive status. The Glasgow Coma Scale and Mini- Mental State Examination (MMSE) were used to evaluate consciousness and cognition. Examination of the Babinski sign was recorded at the onset. The functional outcome was assessed by the Modified Rankin Scale (MRS). Results: All patients initially showed a marked reduction in the level of consciousness, followed by gradual recovery. The mean time to regaining consciousness was 6.8 ± 1.5 days, but the mean time to regaining normal cognition was 21.4 ± 22.0 weeks. Two patients presenting Babinski sign showed longer recovery times compared to others. The mean MMSE score at the first stage was 21.3 ± 1.2, and at the second stage was 28.8 ± 1.9. The MRS scores revealed favorable functional outcomes at the last follow-ups. Conclusion: CFE is a serious condition that has a favorable outcome. Although it is difficult to conclude whether the MMSE score is correlated with the time of recovery, a positive Babinski sign may be a simple clinical indicator of a longer recovery period.