1. October 2020 Critical Care Case of the Month: Unexplained Encephalopathy Following Elective Plastic Surgery
- Author
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Held N and Welsh C
- Subjects
fat embolism ,fat embolism syndrome ,liposuction ,mri ,brain mri ,treatment ,corticosteroids ,mechanism ,symptoms ,review ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 ,Diseases of the respiratory system ,RC705-779 - Abstract
No abstract available. Manuscript truncated after 150 words. A 29-year-old woman with no significant medical history presents to the hospital due to progressive encephalopathy, 5 days after undergoing an elective abdominoplasty with abdominal liposuction and breast augmentation. She is somnolent on exam, and is hypoxic to ~60% saturation on room air. She is emergently intubated in the emergency department prior to being admitted to the MICU, and is started on broad-spectrum antibiotics and n-acetyl cysteine (NAC). She has evidence of acute liver failure but her initial work-up for acute liver failure is entirely unrevealing, and her liver function and hemodynamics improve without additional intervention over the initial 3 days of hospitalization. Unfortunately, her mental status does not improve. Despite weaning of all sedation, she shows limited signs of awareness. A lumbar puncture, CT of the head, and electroencephalogram (EEG) are performed and are unremarkable. What should be done next? 1. Brain magnetic resonance (MRI) imaging 2. Myelography 3. …
- Published
- 2020
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