Pathophysiology, clinical manifestations, and prognostic insights of cerebral fat embolism: a literature review

Cerebral fat embolism (CFE) syndrome, a rare and often incomplete variant of fat embolism syndrome (FES), is characterized by pure neurological involvement and may occur after both traumatic and nontraumatic events. It is typically caused by embolization of fat droplets into the systemic circulation, most commonly after orthopedic trauma. The clinical presentation ranges from subtle neurological symptoms to life-threatening events, including respiratory distress, altered mental status, seizures, and coma. Diagnosis is challenging due to nonspecific signs, concurrent injuries, and lack of definitive diagnostic criteria. Although the Gurd and Wilson and Modified Gurd criteria are widely used, they are not fully validated and may not capture the full clinical picture. Neuroimaging, particularly MRI, plays a key supportive role. Despite investigations into corticosteroids and other pharmacologic agents, no treatment has demonstrated definitive efficacy. Thus, management remains largely supportive. Therefore, prompt recognition, refinement of diagnostic criteria, and further research into reliable biomarkers and targeted therapies are essential for improving CFE outcomes.