Abstract
The neurogenic pulmonary edema is a rare clinical situation caused by an imbalance characterized by an excessive sympathetic outflow. It is observed mostly in young patients, is associated with brain or spinal cord haemorrhage, trauma, tumours or infections and is usually fatal. A case of neurogenic pulmonary edema in a 27-year-old woman is presented, caused by a cerebellar haemorrhage due to a vermian and paravermian arteriovenous malformation rupture. The vermian and hemispheric haemorrhage injuring the sub-lobule IX-b of the uvula induced a disruption of both carotid baroreceptor and chemoreceptor reflexes control mechanisms. Medical treatment with controlled ventilation, PEEP, diuretics and morphine reverted the pulmonary edema. After surgical treatment of the haemorrhage and cerebellar AVM the patient recovered to an almost normal social and professional life. The cerebellar lesion induced a temporary vermian sub lobule IX-b dysfunction that was responsible for the sympathetic storm that evoked the neurogenic pulmonary edema.
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Yahumoto M, Kuriyama T, Iwamoto M, Kinoshita T. Neurogenic pulmonary edema associated with ruptured intracranial aneurysm-case report. Neurosurgery. 1986;19: 300–4.
Bratton S, Davis R. Acute lung injury in isolated traumatic brain injury. Neurosurgery. 1997;40:707–12.
Bradley D, Pascoe J, Paton JFR, Spyer K. Cardiovascular and respiratory responses evoked from the posterior cerebellar cortex and fastigial nucleus in the cat. J Physiol (London). 1987;393:107–21.
Friedman JA, Pichelmann MA, Piepgras DG, et al. Pulmonary complications of aneurysmal subarachnoid hemorrhage. Neurosurgery. 2003;52:1025–30.
Bradley D, Ghelarducci B, Paton JFR, Spyer K. Cardiovascular responses elicited from the posterior cerebellar cortex in the anaesthetized and decerebrate rabbit. J Physiol (London). 1987;383:537–50.
Gonçalves V, Rocha I, Silva-Carvalho L. Silva-Carvalho J. Attenuation of the respiratory component of the carotid body chemoreflex during electrical stimulation of the posterior vermis in the anaesthetized rabbit. J Physiol (London). 1996;494:103P.
Gonçalves V, Rocha I, Silva-Carvalho L. Attenuation of the carotid body chemoreflex during the stimulation of the posterior vermis in the anaesthetized rabbit. Aut Neurosc: Basic Clin. 2002;101:78–84.
Servadei F, Merry GS. Mild head injury in adults. In: Winn HR, editor. Neurological surgery, 5th edn. Saunders: 2004. pp 5065–81.
Lara JP, Parkers M, Silva-Carvalho L, Izzo P, Dawid-Milner M, Spyer K. Cardiovascular and respiratory effects of stimulation of cell bodies of the parabrachial nuclei in the anaesthetized cat. J Physiol (London). 1994;477:321–9.
Paton J, Silva-Carvalho L. Thompson C, Spyer K. Nucleus tractus solitarius as mediator of evoked parabrachial cardiovascular responses in the decerebrate rabbit. J Physiol (London). 1990;428:693–705.
Silva-Carvalho L, Paton J, Goldsmith G, Spyer K. The effects of electrical stimulation of lobule IXb of the posterior cerebellar vermis on neurones within the rostral ventrolateral medulla in the anaesthetized cat. J Auton Nerv Syst. 1991;36:97–106.
Rastogi P, Popp A. Management of respiratory dysfunction in neurosurgical patient. Contemp Neurosurg. 1995;17:14.
Silva-Carvalho L, Dawid-Milner M, Goldsmith G, Spyer K. Hypothalamic evoked effects in the nucleus tractus solitarius in the cat. A mechanism contributing to the facilitation of chemoreceptor reflexes. J Exp Physiol. 1993;78:425–8.
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Gonçalves, V., Silva-Carvalho, L. & Rocha, I. Cerebellar haemorrhage as a cause of neurogenic pulmonary edema-case report. Cerebellum 4, 246–249 (2005). https://doi.org/10.1080/14734220500325863
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DOI: https://doi.org/10.1080/14734220500325863