182 - Interstate Collaboration in Rehabilitating a Patient with Fat Emboli Stroke Secondary to Sickle Cell Disease: A Case Report

Case Diagnosis: Fat emboli stroke secondary to sickle cell disease.

Case Description: A young woman with sickle cell disease developed a multifocal infarct with fat emboli secondary to a sickle cell crisis bone marrow infarction while vacationing in Florida. Magnetic resonance imaging revealed multiple punctate foci of restricted diffusion involving the periventricular, deep, and subcortical white matter, cortex, deep gray nuclei, and corpus callosum. The patient was admitted to the acute hospital in Miami to manage her active medical issues. She was later transferred to the rehabilitation hospital to optimize recovery. The patient ultimately had significant improvements in her strength, sensation, and cognition.

Discussions: The differential diagnosis for ischemic stroke in young patients involves different etiologies including blood disorders, vasculopathy, cardiac defects, recent pregnancy, other hypercoagulable states, smoking, substance misuse, premature atherosclerosis, hypertension, and metabolic disorders. In the rehab process for this patient, collaborations were established between the physiatrist in Miami and her physiatrist in Minnesota to continue her long-term care in her hometown and optimize her recovery. Specific recommendations were made to optimize her return to college, enabled by interstate collaboration between physiatrists.

Conclusions: This report illustrates the value of interstate collaboration in optimizing stroke rehabilitation and the role of physiatrists in the continuum of care for a young stroke patient.