To date, there have been no reports of paroxysmal sympathetic hyperactivity syndrome (PSHS) associated with cerebral fat
embolization. We describe the case of a young male who developed acute brain injury and acute hypoxemic respiratory
failure secondary to significant fat embolization following a traumatic femur injury. Our patient demonstrated episodes of
significant hypertension, tachycardia, fever and extensor posturing. Extensive evaluation lead to the diagnosis and appropriate
treatment for PSHS. Ultimately, the patient went on to have a good neurologic recovery after a prolonged hospitalization.
We will discuss PSHS diagnostic criteria, pathophysiology and treatment options. This diagnosis should be considered in
all brain-injured patients with paroxysms of autonomic instability and abnormal movements