This axial section of the cerebellum and pons reveals multiple petechial hemorrhages, most prominent in the white matter. This "brain purpura" is characteristic of fat embolism syndrome. This patient was involved in a motor vehicle accident and sustained multiple fractures. The fractures were treated and the patient remained stable until the fifth hospital day, at which time he became comatose, and a head CT scan showed brain edema. Fat emboli were present microscopically in small vessels throughout the brain. Older persons are more prone to have massive fat embolism. The lung is most often involved, but kidney and brain can be affected. Though some fat emboli can be found at autopsy in the lungs of persons with bone fractures or extensive soft tissue trauma or burns, only a small percentage of persons develop the fat embolism syndrome. The syndrome may not appear for 1 to 3 days following the injuries, and symptoms of cerebral fat embolism syndrome may appear up to a week following the injuries..