What is Neurogenic Pulmonary Edema?
Neurogenic Pulmonary Edema is quite a rare form of Pulmonary Edema which is caused due to excessive build up of pulmonary interstitial and alveolar fluids. This usually happens after a severe neurologic insult or injury. A Neurogenic Pulmonary Edema may develop within minutes up to a few hours after a neurologic insult and is characterized by episodes of sudden severe shortness of breath and fever. Neurogenic pulmonary edema is usually a diagnosis of exclusion and is diagnosed after every other condition is ruled out causing the symptoms. Treatment for neurogenic pulmonary edema is normally supportive with the focus of actual treatment being to resolve the neurologic condition causing Neurogenic Pulmonary Edema. This condition resolves within two to three days after development.
What is the Cause of Neurogenic Pulmonary Edema?
There is no definite cause for neurogenic pulmonary edema but it usually develops after a severe neurologic insult and develops within minutes to hours after the neurologic insult. Some of the major causes of neurogenic pulmonary edema are subarachnoid hemorrhage, cerebral hemorrhage, seizures, or a traumatic head injury as a result of a motor vehicle crash and the like. Some of the minor causes of neurogenic pulmonary edema are no hemorrhagic strokes, air embolism, or brain tumors, and bacterial meningitis.
What are the Symptoms of Neurogenic Pulmonary Edema?
Some of the common symptoms of Neurogenic Pulmonary Edema are:
- Sudden onset shortness of breath
- Rapid heartbeat
- Bibasilar crackles
How is Neurogenic Pulmonary Edema Diagnosed?
The diagnosis of neurogenic pulmonary edema is normally a diagnosis of exclusion. There are no specific tests which can determine whether an individual has neurogenic pulmonary edema apart from the cardiac markers being elevated. If this is the case then it may point to a neurological insult and that too subarachnoid hemorrhage which is the most common cause of neurogenic pulmonary edema. Radiological studies in the form of chest radiographs will show an appearance similar to that of a congestive heart failure but other tests to confirm that will be negative. This leaves with only one diagnosis and that is neurogenic pulmonary edema.
What are the Treatments for Neurogenic Pulmonary Edema?
The treatment for neurogenic pulmonary edema is basically supportive with the focus of treatment being to treat the underlying neurologic cause of the condition. Neurogenic pulmonary edema normally resolves within 72 hours of its onset in majority of the cases. For treatment, supplemental oxygen is required to control the severe shortness of breath experienced by the patient suffering from neurogenic pulmonary edema. In some cases mechanical ventilation may also be required for some time till the edema resolves and the patient is able to breathe normally again. Artificial ventilation assures that there is no injury to the lungs due to neurogenic pulmonary edema. It is also important to maintain oxygenation to the vital organs of the body during this phase of neurogenic pulmonary edema. At times, certain medications like beta blockers and alpha adrenergic agents can be used but usually it is not required as this condition is self limited and resolves on its own within two to three days of its onset.
Surgery by far has never been required for specific treatment of neurogenic pulmonary edema, although surgery is required for the cause of it like a subdural hematoma or a cerebral hemorrhage which are known to cause neurogenic pulmonary edema.