Acta clinica Croatica, Vol. 43 No. 4, 2004.
Case report
Neurogenic Pulmonary Edema
Vesna Šerić
Marina Roje-Bedeković
Vida Demarin
Abstract
The association of pulmonary edema with central nervous system disease without underlying cardiopulmonary disease is known as neurogenic pulmonary edema (NPE). The most common precipitants of NPE are epileptic seizures, head injury, and subarachnoid or intracerebral hemorrhage. Since the most common neurologic events are associated with increased intracranial pressure, intracranial hypertension is considered to be a key etiologic factor. Various theories regarding the pathogenesis of NPE have been focused on the potential roles for the hypothalamus, the medulla, elevated intracranial pressure, and activation of the sympathoadrenal system. A distinctive form of myocardial injury, contraction band necrosis, is the likely pathologic substrate of cardiac injury. NPE characteristically presents within minutes to hours of a severe central nervous system insult. Resolution of NPE usually occurs within several days. Dyspnea is the most common NPE associated symptom, and mild hemoptysis is also present in many patients. Definitive diagnosis of NPE is difficult because of the nonspecific nature of the clinical signs and routine diagnostic tests. The outcome of patients with NPE is usually determined by the course of the neurologic insult that has produced NPE, and specific treatment should focus on the underlying disorder. NPE is generally managed in a supportive and conservative fashion because many cases of NPE are well tolerated and the majority of them resolve within 48 to 72 hours.
Keywords
Lung - physiopathology; Lung diseases - physiopathology; Pulmonary edema - physiopathology; Pulmonary edema - etiology; Pulmonary edema - diagnosis; Brain diseases - complications
Hrčak ID:
14563
URI
Publication date:
1.12.2004.
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