Neurogenic Pulmonary Edema Following Acute Cerebral Infarction

Abstract

Background: Neurogenic pulmonary edema is non-cardiogenic pulmonary edema due to sudden excessive activation of sympathetic system after central nervous system injury. We report an acute cerebral infarction patient who developed neurogenic pulmonary edema requiring intubation and mechanical ventilation care. Case Report: A 77-year-old Korean woman visited emergency room complaining of sudden onset right side weakness which started one hour ago. She had a history of atrial fibrillation with normal ejection fraction. Neurological examination revealed motor aphasia and right side weakness. Brain computerized tomography angiography showed left middle cerebral artery occlusion without frank ischemic change. Intravenous thrombolytic therapy was considered, but suspended because she suddenly complained of respiration difficulty. Conclusions: This case suggests that large hemispheric infarction can result in acute onset pulmonary edema which is severe enough to require intubation and to delay thrombolytic treatment.