• Patrick Gibbons, Maura Kennedy, Pierre Borczuk, and Da'Marcus Baymon.
• Department of Emergency Medicine, Combined Massachusetts General Hospital and Brigham and Women's Hospital, Boston, Massachusetts.
• J Emerg Med. 2022 Oct 1; 63 (4): e87e90e87-e90.

BackgroundCerebral fat embolism is a rare diagnosis that can occur after significant long bone trauma. Most patients have evidence of pulmonary involvement, but this case involved a patient with a pure neurologic manifestation of a fat embolism.Case ReportAn 89-year-old woman presented to the emergency department as a transfer from an outside hospital with a diagnosis of air embolism after an episode of altered mental status and expressive aphasia. A secondary review of the patient's computed tomography angiography head imaging uncovered a cerebral fat embolism as the cause of the patient's acute neurologic event. The cerebral fat embolism was likely from a remote sacral fracture 6 weeks prior. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When a patient presents with a concern for a stroke-like symptoms and a cerebral fat embolism is diagnosed, a thorough examination of the patient must be performed to identify the primary fracture site. Geriatric long bone fractures have well-known significant morbidity and mortality. An associated cerebral fat embolism can increase that mortality and morbidity and prompt diagnosis is important.Copyright © 2022. Published by Elsevier Inc.

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