Neurogenic Pulmonary Edema Caused by Subarachnoid Hemorrhage: A Case Report

What is it about?

Neurogenic pulmonary edema is a serious and life-threatening complication caused by central nervous system diseases, excluding cardiogenic pulmonary edema, other causes of pulmonary edema, lung injury, etc. The lack of specific diagnostic criteria for NPE and the lack of awareness among clinicians often lead to underdiagnosis and misdiagnosis. The disease progresses rapidly with poor prognosis and high mortality [1]. In this paper, we report a patient with a ruptured right middle cerebral artery aneurysm causing subarachnoid hemorrhage, who developed neurogenic pulmonary edema and underwent elective aneurysm clamping under general anesthesia. The relevant perioperative management is reported as follows, and the anesthesia management of patients with neurogenic pulmonary edema is analyzed in the context of the relevant literature.

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Photo by Diana Polekhina on Unsplash

Photo by Diana Polekhina on Unsplash

Why is it important?

Neurogenic pulmonary edema is not uncommon in neurosurgical patients with aneurysmal subarachnoid hemorrhage, which usually occurs on the same day of hemorrhage and subsides in the following days. However, if a re-rupture of the aneurysm occurs, the condition can worsen dramatically and progress rapidly, with a poor prognosis. Therefore, early detection and early treatment of neurogenic pulmonary edema disease are more effective, but there are no specific manifestations in the early stage, which makes the diagnosis more difficult. Therefore, clinical awareness of this disease needs to be improved.

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