PM&R Meeting Abstracts

Official abstracts site for the AAPM&R Annual Assembly and the PM&R Journal.

MENU 
  • Home
  • Meetings Archive
    • AAPM&R Annual Assembly 2022
    • AAPM&R Annual Assembly 2021
    • AAPM&R Annual Assembly 2020
    • AAPM&R Annual Assembly 2019
  • Resources
  • Advanced Search

Time Really Is Brain – Rapid Cognitive Recovery in a Patient with Cerebral Fat Embolism: A Case Report

Jason L. Kessler, MD (New York University Grossman School of Medicine PM&R Program, New York City, New York); Ariane Osterwald; Mark Ragucci, DO

Meeting: AAPM&R Annual Assembly 2022

Categories: Neurological Rehabilitation (2022)

Session Information

Session Title: AA 2022 Posters - Neurological Rehabilitation

Session Time: None. Available on demand.

Disclosures: Jason L. Kessler, MD: No financial relationships or conflicts of interest

Case Diagnosis: Multifocal cerebral infarcts secondary to fat embolisms in the setting of long-bone polytrauma.

Case Description or Program Description: A 57-year-old man presented as a Level 2 trauma with bilateral lower extremity deformities after being pinned by a vehicle. He was neurologically intact on presentation and underwent external fixation of left femoral and tibial shaft fractures. Post-op Stroke Code was called for significant encephalopathy and left arm weakness. Patient was noted to have a generalized response to stimuli and was cognitively equivalent to a minimally conscious state. Brain MRI revealed multiple punctate lesions concerning for fat embolisms involving the bilateral frontal, parietal, and occipital lobes. Echocardiogram revealed an intrapulmonary shunt, and an IVC filter was placed.

Setting: Metropolitan Level 1 Trauma Center.

Assessment/Results: Four days after the onset of encephalopathy, the patient made remarkable neurological recovery with bedside therapy, demonstrating mild cognitive and communication deficits and mild dysarthria. His neurological recovery continued after admission to acute inpatient rehab. The patient was discharged from the speech-language service with only mild working memory impairments two weeks after the initial appearance of encephalopathy.

Discussion (relevance): Previous literature on cerebral fat embolisms report neurological recovery three weeks to four months after the initial insult, not days as was seen in this patient. Besides early bedside cognitive therapy while in the ICU, it is unclear how this patient’s recovery advanced so rapidly compared to other cases. Furthermore, there is a lack of knowledge in the rehab community regarding specific rehabilitation guidelines for cerebral fat embolisms, especially the timing and duration for therapy.

Conclusions: A prospective community-wide analysis of trauma patients complicated by fat embolisms would be beneficial for identifying prognostic factors for neurological recovery and for outlining treatment guidelines to optimize the rehab potential for these patients.

Level of Evidence: Level V

To cite this abstract in AMA style:

Kessler JL, Osterwald A, Ragucci M. Time Really Is Brain – Rapid Cognitive Recovery in a Patient with Cerebral Fat Embolism: A Case Report [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/time-really-is-brain-rapid-cognitive-recovery-in-a-patient-with-cerebral-fat-embolism-a-case-report/. Accessed May 30, 2025.
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to AAPM&R Annual Assembly 2022

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/time-really-is-brain-rapid-cognitive-recovery-in-a-patient-with-cerebral-fat-embolism-a-case-report/

Leading the Way. Baltimore, MD & Virtual. October 20-23, 2022. #aapmr22

PM&R Journal

View issues of PM&R on the Wiley Online Library »

American Academy of Physical Medicine and Rehabilitation

Visit the official site for the American Academy of Physical Medicine and Rehabilitation »

AAPM&R Annual Assembly

Visit the official site for the AAPM&R Annual Assembly »

  • Help & Support
  • About Us
  • Cookies & Privacy
  • Wiley Job Network
  • Terms & Conditions
  • Advertisers & Agents
Copyright © 2025 John Wiley & Sons, Inc. All Rights Reserved.
Wiley