Fat Embolism Case Study

Mr BW was a 74-year-old man who had a fall due to a new onset of seizures, which resulted, to a direct impact of his head on the ground while at home. While at the hospital, MR BW underwent a CT and MRI brain scan and showed a haematoma, which resulted to commencing of the patient on Keppra and Bezodiapenes. Moreover, Mr BW also developed a sudden onset of pleuretic chest pain, which was confirmed by CTPA as a small pleural effusion on the left lungs; while there was also pulmonary embolism on both upper and lower lobes of the left lung. Due to the development of a provoked pulmonary embolism, patient commenced on Clexane injection. In September 2015, an elective open abdominoperineal resection was performed on Mr BW, which resulted to prolonged stay in the hospital due to delayed wound healing.

Different types of intracranial hemorrhages can occur due to injuries to the skull, either directly or indirectly. Epidural hematomas occur when a direct blow to the skull causes injury to the dural arteries or veins that lead to bleeding that accumulates between the dura matter and the skull. If the dural artery is injured, rapid deterioration of the patient neurologic status can occur. As the size of the epidural hematoma increases, the surrounding brain tissues is damaged due to the compression from the pressure of the blood accumulation. The patient may experience a dilated pupil on the side of the injury due to compression of the third cranial nerve. The patient may also complain of a severe headache, visual disturbances and weakness on the opposite side of the injury. If bleeding continues and increases the intracranial pressure, leading to brain shift or herniation of the brain stem which is irreversible and leads to hypertension, bradycardia and respiratory arrest. This trio of symptoms is called the Cushing’s Triad. Epidural hematomas can continue

It doesn’t contain blood vessel and is nourished by the diffusion from the bone. Adipose, is another term for fatty tissue. It is common for under the skin and around the organs such as the heart, kidney and part of the digestive tract.

1-Mr. Franklin had dizziness and was found on the floor. From his history, we know that two years ago he had a thrombotic cerebrovascular accident. The thrombotic cerebrovascular accident is unexpected death of some brain cells because of lack of oxygen when the blood supply to the brain is blocked by blood clots. This is also called stroke or CVA. This traumatic brain injury is related to blood vessel damage. Seizures and dizziness are some of the physical symptoms. We can rule out traumatic brain injuries like fluid buildup in the brain that could cause the brain to swell; skull fractures or wounds that can tear the meninges pooling blood outside the vessels and enabling the bacteria to infect the nervous system.

Patient is a 23-year-old right-hand white female who presents with her mother for evaluation of post concussive syndrome. She had two significant closed head injuries this winter in February. They both occurred while snowboarding. On the first one, she slipped on some ice fell back and hit her occiput. She was wearing a helmet. When she got down to the bottom of the hill, she noted she had some mild confusion. Her friend asked her where she fell and she was unable to recall exactly where in the course she fell. She had a mild headache and was sleepy the rest of that day. One week later, she had another strike to the occiput. Again, she was wearing a helmet. She did have a headache

Patient S is a seventy-eight-year-old male who presented to the ED in Rushville on October 25th with signs and symptoms of a stroke. These symptoms were leaning to the left side, a left facial droop, weakness in the left arm, and ataxia. The patient has no history of stroke. Patient S was admitted to 4-G in Memorial for a right-sided ischemic stroke. The patient has a history of atrial fibrillation (A-Fib), hyperlipidemia, bleeding problems, hypertension, sleep apnea, and a pacemaker. Patient S lives at home with his wife. Patient S was independent before the stroke. On October 13th, the patient had surgery of lumbar stenosis on L3, L4, and L5. The patient and wife reported increased serosanguinous drainage that soaked the dressing. Patient denied fever or pain at incision site. The doctor decreased Warfarin from 5 milligrams (mg) to 2.5 mg and prescribed a full dose of aspirin.

The withdrawn excess fat is then injected into the new location, wherever the patient and (insert Dr name here) have decided it would best suit, to complete the necessary plumping. This area will re-vascularize as the healing process goes on, which will take a very minimal amount of time. The bodily fat transfer procedure will be repeated as many times necessary until the desired plumping correction has been fully achieved to the patient's pre-planned desire, and can also be combined with any other surgical procedure that (insert Dr name here) has recommended during the initial consultation and planning

Hemorrhagic transformation: It may occur one to two days after infection. It is manifested by neurological worsening and gradual loss of consciousness. Ischemic cerebral edema / pressure: is the development of profuse quantities of fluid collecting in brain tissue. Pressure sores or bedsores due to person are in a sitting or lying position for too long

It is also unclear if it is the brain injury itself that causes the result and if it is the same for healthy people.

You need to return to the ER if you: Develop a fever of 100.4 F or shaking chills, note increased drainage or odor coming from the wound, develop redness or swelling in or around the wound, increased pain. If you develop signs and symptoms of hypoglycemia such as confusion, anxiety, blurred vision, shakiness, loss of consciousness, hunger make sure you take glucose tablets, drink juice, or eat candy and call the medical doctor or go to the closest emergency department if the issues are unresolved.

The following are symptoms according to the American Red Cross Nursing Assistant text book the patient could experience: “Slurring of words, Drooping of the features on one side of the face (for example, the eyelid and the corner of the mouth), trouble seeing in one or both eyes, weakness or numbness in an arm or leg, a sudden, severe headache, dizziness or loss of balance, confusion, or a loss of consciousness, a generally ill appearance, or abnormal behavior” (Page 91). Our text book in chapter 18 calls the weakness hemiparesis and the paralysis is called hemiplegia. These are experienced on one side of the body. F.A.S.T is a great way to check

In some case patients may have more than just these symptoms such as paralysis or weakness on the right side of the body, vision on the right maybe limited or decreased (hemianopsia), object recognition (apraxia), memory of said words, etc. These symptoms vary according to the area of injury.

The initial computed tomography (CT) scan of her head revealed multifocal, punctuate brain hemorrhages, consistent with a diffuse axonal injury (DAI). (Figure 1) CT scans of the cervical spine, chest, abdomen, and pelvis revealed bilateral spinous process fractures of C7, T1, and T2, a mid sternal body fracture, bilateral pulmonary contusions, and a distal right clavicle fracture. She also sustained a cardiac contusion associated post-injury arrhythmias, which were treated conservatively. An external ventricular drainage device was placed by neurosurgery to help monitor and manage her intracranial pressure and maintain her cerebral perfusion pressure within acceptable limits.

After reading through the case study information and considering everything possible, the provisional diagnosis for this patient is a traumatic brain injury. Along with the TBI, there is also an associated linear skull fracture and intracranial haemorrhage (epidural

Eventually this obstruction leads to the lack of blood and oxygen to the heart, which ultimately results in a heart attack (NHLBI.com, 2005).