Neurogenic pulmonary oedema complicating traumatic posterior fossa extradural haematoma: Case report and review

Ajay Hegde, G. Lakshmi Prasad, Priyanka Kini

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Pulmonary oedema is accumulation of fluid in the lung air spaces and interstitia. Neurogenic pulmonary oedema (NPE) is a potentially life-threatening condition which has been noted in head injury, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and others. Timely management is crucial to achieve good outcome; however, no specific guidelines have been defined. Methods: A 33-year female involved in a motor vehicular accident had a GCS of 14/15 and CT scan showed a moderate-sized unilateral posterior fossa extradural haematoma (PFEDH). She had sudden deterioration in her haemodynamic status with drop in sensorium 2 hours after admission. There was a copious amount of frothy secretions noted on intubation and she was diagnosed as having NPE. Results: Sub-occiptial craneictomy (SOC) with haematoma evacuation was performed and was managed with PEEP mechanical ventilation post-operatively. Excellent outcome was obtained and was discharged with a GOS of 5. Conclusions: NPE is a poorly understood and uncommon complication of acute CNS injury and should be considered in any patient with acute respiratory distress in the setting of CNS injury. Reduction in ICP and supportive mechanical ventilation form the mainstay of management. Diagnosis of NPE remains challenging and more reliable diagnostic criteria need to be defined to identify such cases with greater frequency.

Original languageEnglish
Pages (from-to)127-130
Number of pages4
JournalBrain Injury
Volume31
Issue number1
DOIs
Publication statusPublished - 02-01-2017

Fingerprint

Pulmonary Edema
Hematoma
Artificial Respiration
losigame
Cerebral Hemorrhage
Wounds and Injuries
Subarachnoid Hemorrhage
Craniocerebral Trauma
Intubation
Accidents
Hemodynamics
Air
Central Nervous System
Guidelines
Lung
Admission
Deterioration
Diagnostics
Complications
Head Injury

All Science Journal Classification (ASJC) codes

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

@article{ee385029ca2543af8b780368fe9e36cc,
title = "Neurogenic pulmonary oedema complicating traumatic posterior fossa extradural haematoma: Case report and review",
abstract = "Introduction: Pulmonary oedema is accumulation of fluid in the lung air spaces and interstitia. Neurogenic pulmonary oedema (NPE) is a potentially life-threatening condition which has been noted in head injury, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and others. Timely management is crucial to achieve good outcome; however, no specific guidelines have been defined. Methods: A 33-year female involved in a motor vehicular accident had a GCS of 14/15 and CT scan showed a moderate-sized unilateral posterior fossa extradural haematoma (PFEDH). She had sudden deterioration in her haemodynamic status with drop in sensorium 2 hours after admission. There was a copious amount of frothy secretions noted on intubation and she was diagnosed as having NPE. Results: Sub-occiptial craneictomy (SOC) with haematoma evacuation was performed and was managed with PEEP mechanical ventilation post-operatively. Excellent outcome was obtained and was discharged with a GOS of 5. Conclusions: NPE is a poorly understood and uncommon complication of acute CNS injury and should be considered in any patient with acute respiratory distress in the setting of CNS injury. Reduction in ICP and supportive mechanical ventilation form the mainstay of management. Diagnosis of NPE remains challenging and more reliable diagnostic criteria need to be defined to identify such cases with greater frequency.",
author = "Ajay Hegde and Prasad, {G. Lakshmi} and Priyanka Kini",
year = "2017",
month = "1",
day = "2",
doi = "10.1080/02699052.2016.1219388",
language = "English",
volume = "31",
pages = "127--130",
journal = "Brain Injury",
issn = "0269-9052",
publisher = "Informa Healthcare",
number = "1",

}

Neurogenic pulmonary oedema complicating traumatic posterior fossa extradural haematoma : Case report and review. / Hegde, Ajay; Prasad, G. Lakshmi; Kini, Priyanka.

In: Brain Injury, Vol. 31, No. 1, 02.01.2017, p. 127-130.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Neurogenic pulmonary oedema complicating traumatic posterior fossa extradural haematoma

T2 - Case report and review

AU - Hegde, Ajay

AU - Prasad, G. Lakshmi

AU - Kini, Priyanka

PY - 2017/1/2

Y1 - 2017/1/2

N2 - Introduction: Pulmonary oedema is accumulation of fluid in the lung air spaces and interstitia. Neurogenic pulmonary oedema (NPE) is a potentially life-threatening condition which has been noted in head injury, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and others. Timely management is crucial to achieve good outcome; however, no specific guidelines have been defined. Methods: A 33-year female involved in a motor vehicular accident had a GCS of 14/15 and CT scan showed a moderate-sized unilateral posterior fossa extradural haematoma (PFEDH). She had sudden deterioration in her haemodynamic status with drop in sensorium 2 hours after admission. There was a copious amount of frothy secretions noted on intubation and she was diagnosed as having NPE. Results: Sub-occiptial craneictomy (SOC) with haematoma evacuation was performed and was managed with PEEP mechanical ventilation post-operatively. Excellent outcome was obtained and was discharged with a GOS of 5. Conclusions: NPE is a poorly understood and uncommon complication of acute CNS injury and should be considered in any patient with acute respiratory distress in the setting of CNS injury. Reduction in ICP and supportive mechanical ventilation form the mainstay of management. Diagnosis of NPE remains challenging and more reliable diagnostic criteria need to be defined to identify such cases with greater frequency.

AB - Introduction: Pulmonary oedema is accumulation of fluid in the lung air spaces and interstitia. Neurogenic pulmonary oedema (NPE) is a potentially life-threatening condition which has been noted in head injury, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and others. Timely management is crucial to achieve good outcome; however, no specific guidelines have been defined. Methods: A 33-year female involved in a motor vehicular accident had a GCS of 14/15 and CT scan showed a moderate-sized unilateral posterior fossa extradural haematoma (PFEDH). She had sudden deterioration in her haemodynamic status with drop in sensorium 2 hours after admission. There was a copious amount of frothy secretions noted on intubation and she was diagnosed as having NPE. Results: Sub-occiptial craneictomy (SOC) with haematoma evacuation was performed and was managed with PEEP mechanical ventilation post-operatively. Excellent outcome was obtained and was discharged with a GOS of 5. Conclusions: NPE is a poorly understood and uncommon complication of acute CNS injury and should be considered in any patient with acute respiratory distress in the setting of CNS injury. Reduction in ICP and supportive mechanical ventilation form the mainstay of management. Diagnosis of NPE remains challenging and more reliable diagnostic criteria need to be defined to identify such cases with greater frequency.

UR - http://www.scopus.com/inward/record.url?scp=84996992933&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84996992933&partnerID=8YFLogxK

U2 - 10.1080/02699052.2016.1219388

DO - 10.1080/02699052.2016.1219388

M3 - Article

C2 - 27880060

AN - SCOPUS:84996992933

VL - 31

SP - 127

EP - 130

JO - Brain Injury

JF - Brain Injury

SN - 0269-9052

IS - 1

ER -