Cerebral fat embolism presenting as paroxysmal sympathetic hyperactivity

Traumatic injuries and procedures under anesthesia can both predispose patients to altered mental status for many reasons. In this case, a 21 year old man presented with an isolated femur fracture and developed paroxysmal sympathetic hyperactivity after surgical fixation. This case highlights the diagnostic considerations when a trauma patient develops dysautonomia and altered mental status and explores therapeutic options for treating a patient with sympathetic storming.