Is Paradoxical Embolism Associated with Neurological Dysfunction After Long-Bone Fracture?

Transcranial Doppler (TCD) ultrasound, the only imaging technique that can detect circulating cerebral emboli, has been widely applied to patients with large-artery atherosclerotic stenosis. The presence of microembolic signals can predict stroke risk in patients with either symptomatic or asymptomatic carotid stenosis. Emboli are detected as short-duration, high-intensity signals because they reflect more ultrasound than the surrounding red blood cells.

Researchers have now applied TCD ultrasound imaging to 42 patients admitted to a trauma center within 48 hours after sustaining a fracture of the femoral shaft. The goal was to determine, prospectively, whether emboli (presumed to have resulted from fat) play a role in the neurological featu…