Medullary lesion inducing pulmonary edema: A magnetic resonance imaging study

Simon, Roger P.; Gean-Marton, A D; Sander, James E.

doi:10.1002/ana.410300515

Cited by 50 publications

(36 citation statements)

References 14 publications

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“…Both experimental and clinical studies show that destruction or mechanical compression of the dorsal and solitary tract nuclei, which suppress sympathetic activity, leads to acute change in pulmonary vascular permeability and subsequent NPE. 13,22,23,30) A lesion in the solitary tract nucleus also seems to alter the secretion of brain natriuretic peptide, which may also be involved in the pathogenesis of NPE. 6,7) These findings may explain why poor-grade patients with ruptured posterior circulation aneurysm were significantly more likely to sustain NPE compared with anterior circulation aneurysm, as previously reported.…”

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confidence: 99%

Subarachnoid Hemorrhage Complicated With Neurogenic Pulmonary Edema and Takotsubo-Like Cardiomyopathy

Inamasu

Nakatsukasa

Mayanagi

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Patients with poor-grade subarachnoid hemorrhage (SAH) are often complicated with acute cardiopulmonary dysfunctions, particularly neurogenic pulmonary edema (NPE) and takotsubo-like cardiomyopathy (TCM). This study retrospectively investigated the incidence, demographics, clinical characteristics, and outcomes of patients with SAH complicated with both NPE and TCM (NPE-TCM). The effects of aneurysm location and other clinical variables on the incidence of NPE-TCM were also investigated. Among 234 SAH patients treated during 5-year period, 16 (7%) presented with NPE, and transthoracic ultrasonography revealed that 14 of these 16 patients (88%) also had TCM. All 14 patients with NPE-TCM had poor-grade SAH (World Federation of Neurosurgical Societies grades IV and V). Ruptured posterior circulation aneurysm was predictive of NPE-TCM, but other clinical variables were not. Eight of the 14 patients with NPE-TCM could undergo treatment for ruptured aneurysm. Long-term outcomes were favorable in 5 of the 8 patients. Grade IV SAH patients had significantly better outcomes than grade V patients. TCM develops frequently in SAH patients presenting with NPE, and transthoracic ultrasonography should be conducted routinely in that population. Patients with ruptured posterior circulation aneurysm may have elevated risk of developing NPE-TCM. Endovascular obliteration of the aneurysm may be preferable to open surgery, but the optimal treatment modality needs to be evaluated further. Considering the limited number of SAH patients complicated with NPE-TCM, a multi-center cooperative study may be required.

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confidence: 99%

Subarachnoid Hemorrhage Complicated With Neurogenic Pulmonary Edema and Takotsubo-Like Cardiomyopathy

Inamasu

Nakatsukasa

Mayanagi

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…Several case reports have shown new brainstem or cervical cord lesions associated with APO in relapses of MS [1][2][3][4][5]. Relapses with APO were typically preceded within hours or days by upper limb parasthesias, headache or visual disturbance [5].…”

Section: Discussionmentioning

confidence: 98%

Neurocardiogenic Pulmonary Oedema: Initial Presentation of Multiple Sclerosis

Padley

Feneley

Hayward

et al. 2012

Heart, Lung and Circulation

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“…In most cases the precise CNS lesion site directly associated with NPE could not be identified. According to some case reports and animal experiments these 'NPE trigger zones' include the hypothalamus and the medulla [3][4][5]. We report a case where NPE was induced by a bilateral medial medullary infarction (BMMI), a rare stroke syndrome per se.…”

Section: Sirmentioning

confidence: 95%