Neurogenic pulmonary edema: a case report and literature review

Abstract

We report a case of neurogenic pulmonary edema (NPE) caused by an intraparenchymal bleed following a fall. We review the literature regarding the pathophysiology, clinical presentation, and management of neurogenic pulmonary edema. Pulmonary edema is the accumulation of fluid within the alveolar and interstitial spaces; one of the lesser-appreciated causes is neurogenic. NPE occurs following acute central nervous system (CNS) injury and is often rapidly developing in nature. Common insults include epileptic seizures, traumatic brain injury, intracranial hemorrhage, and pediatric encephalitis The low prevalence of NPE and the distracting primary disease often divert physicians' attention away from its prompt diagnosis, this is regrettable as up to 35% of patients with intracranial hemorrhage have NPE. NPE is a prevalent yet underdiagnosed disease. The underlying mechanisms are still debatable and much more research is required to diagnose and treat the condition effectively. Treatment is mainly supportive with judicious use of invasive ventilation and management of primary pathology. We aimed to refresh the knowledge of young clinicians regarding NPE. Abbreviations: AVM - arteriovenous malformation; CNE - central nervous system; NPE - Neurogenic pulmonary edema; SAH - subarachnoid hemorrhage; SUDIP - sudden unexplained death in epilepsy Keywords: Neurogenic, Pulmonary edema, Pathophysiology, Presentation, Prevalence, Treatment. Citation: Shahid D, Malik M, Saqib M, Faris S, Khan AU, Qaisar HAA. Neurogenic pulmonary edema: a case report and literature review. Anaesth. pain intensive care 2024;28(3):588−592; DOI: 10.35975/apic.v28i3.2455 Received: September 23, 2023; Revised: April 16, 2024; Accepted: April 16, 2024