[Neurogenic pulmonary edema: a prospective study based on observation].

BACKGROUND: In this study, we evaluated the cause and the clinical course of neurogenic pulmonary edema which has developed abruptly in some of the patients in the neurosurgical intensive care unit. METHODS: We evaluated 223 patients in the neurosurgical ICU (116 males; 107 females; mean age 44.4+/-19.5). Five of these had worsening in neurological evaluation and oxygenation and were diagnosed as having a neurogenic pulmonary edema. Patients with pneumonia were excluded from the study. RESULTS: We identified acute hydrocephaly in three patients and re-bleeding of an aneurysm in one as the cause of neurogenic pulmonary edema. No cause could be identified in the remaining patient. Although four patients could be discharged from the ICU, one died due to multiorgan failure. CONCLUSION: Physicians should be careful about neurogenic pulmonary edema, a life-threatening clinical condition, that develops within hours of a neurologic event and usually resolves with neurologic recovery.