Article Data

  • Views 1846
  • Dowloads 224

Case Reports

Open Access

Hyper-acute neurogenic pulmonary oedema in a prehospital setting: a case report

  • Lucija Galič1
  • Andrej Fabjan2,3
  • Vesna Homar1,2

1Community Health Centre Vrhnika, 1360 Vrhnika, Slovenia

2Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia

3Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia

DOI: 10.22514/sv.2021.087 Vol.17,Issue 4,July 2021 pp.208-211

Submitted: 13 October 2020 Accepted: 09 March 2021

Published: 08 July 2021

*Corresponding Author(s): Lucija Galič E-mail:


Introduction: Neurogenic pulmonary oedema (NPO) is a form of pulmonary oedema which can develop after an acute central nervous system (CNS) lesion, most often a subarachnoid haemorrhage (SAH). Its pathogenesis is associated with a surge of catecholamines which are released into the systemic circulation following an abrupt increase in intracranial pressure or a strategic CNS lesion. NPO typically presents with dyspnoea, tachypnoea, hypoxia, pink frothy sputum, bilateral crackles on auscultation, and bilateral infiltrates on chest X-ray in a few hours or days following the event.

Case report: The following case report describes a case of hyper-acute NPO following a SAH, which presented as acute respiratory failure in the minutes after the event and required fast and aggressive treatment in the prehospital setting.

Conclusion: The management of NPO is primarily focused on prompt diagnosis and treatment of a CNS event and supportive care.


Pulmonary oedema; Prehospital emergency care; Neurology

Cite and Share

Lucija Galič,Andrej Fabjan,Vesna Homar. Hyper-acute neurogenic pulmonary oedema in a prehospital setting: a case report. Signa Vitae. 2021. 17(4);208-211.


[1] Baumann A, Audibert G, McDonnell J, Mertes PM. Neurogenic pulmonary edema. Acta Anaesthesiologica Scandinavica. 2007; 51: 447–455.

[2] Junttila E, Ala-Kokko T, Ohtonen P, Vaarala A, Karttunen A, Vuolteenaho O, et al. Neurogenic pulmonary edema in patients with nontraumatic intracerebral hemorrhage: predictors and association with outcome. Anesthesia & Analgesia. 2013; 116: 855–861.

[3] Davison DL, Terek M, Chawla LS. Neurogenic pulmonary edema. Critical Care. 2012; 16: 212.

[4] Cheung RT, Hachinski V. The insula and cerebrogenic sudden death. Archives of Neurology. 2000; 57: 1685–1688.

[5] Raja HM, Herwadkar AV, Paroutoglou K, Lilleker JB. Neurogenic pulmonary oedema complicating a lateral medullary infarct. BMJ Case Reports. 2018; 2018: bcr2018225437.

[6] Bruder N, Rabinstein A. Cardiovascular and pulmonary complications of aneurysmal subarachnoid hemorrhage. Neurocritical Care. 2011; 15: 257–269.

[7] Macmillan CSA, Grant IS, Andrews PJD. Pulmonary and cardiac sequelae of subarachnoid haemorrhage: time for active management?Intensive Care Medicine. 2002; 28: 1012–1023.

[8] Chen P, Chen LS, Fishbein MC, Lin S, Nattel S. Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy. Circulation Research. 2014; 114: 1500–1515.

[9] Fontes RBV, Aguiar PH, Zanetti MV, Andrade F, Mandel M, Teixeira MJ. Acute neurogenic pulmonary edema: case reports and literature review. Journal of Neurosurgical Anesthesiology. 2003; 15: 144–150.

[10] Muroi C, Keller M, Pangalu A, Fortunati M, Yonekawa Y, Keller E. Neurogenic pulmonary edema in patients with subarachnoid hemorrhage. Journal of Neurosurgical Anesthesiology. 2008; 20: 188–192.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time