Striking corpus callosum lesions in immediate cerebral fat embolism: A rare clinical case

Fat embolism syndrome (FES) is a known complication of long-bone fractures, typically occurring 24–48 h post-trauma and characterized by petechial rash, neurological symptoms, and pulmonary distress. Cerebral fat embolism (CFE), which can be fatal, can result from brain emboli. We report a case of a 17-year-old male who sustained bilateral closed femur fractures in a road traffic accident. The patient presented with immediate neurological distress, including coma, without respiratory symptoms. The brain's CT scan was normal initially. Still, an MRI later showed signs of FES, such as T2 and diffusion hyperintensities on the corpus callosum, a lipid peak on spectroscopy, and a microbleed. Delayed awakening and status epilepticus, treated with anticonvulsants, complicated the patient's course. This case highlights the diagnostic utility of MRI in detecting CFE. It emphasizes the need to consider FES in isolated neurological symptoms following long-bone fractures, even without respiratory distress. Early surgical fixation of fractures remains critical for prevention.