Neurogenic Pulmonary Edema Clinical Presentation

Updated: Dec 31, 2015
  • Author: Tej K Naik, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Presentation

History

Neurogenic pulmonary edema (NPE) characteristically presents within minutes to hours of a severe central nervous system insult.

Sudden onset of dyspnea is the most common symptom; mild hemoptysis also may occur.

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Physical

Physical findings include the following:

  • Tachypnea

  • Tachycardia

  • Bibasilar crackles

  • Respiratory distress

  • Pulmonary edema occurs but with normal jugular venous pressure and an absence of cardiac gallop, which should raise the possibility of a neurogenic cause

  • Fever - May occur secondary to the neurological disturbance (eg, subarachnoid hemorrhage)

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Causes

Major causes

  • Subarachnoid hemorrhage [12, 13, 14]

  • Cerebral hemorrhage [15]

  • Epileptic seizures

  • Head injury [16]

Minor causes

  • Multiple sclerosis with medullary involvement

  • Nonhemorrhagic strokes [17]

  • Bulbar poliomyelitis

  • Air embolism

  • Brain tumors

  • Electroconvulsive therapy

  • Bacterial meningitis

  • Cervical spinal cord injury

  • Intracranial endovascular therapy [18]

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