A change of position for neurogenic pulmonary edema.
BACKGROUND
Stroke is the third most common cause of death in the Western World and is a condition seen by Neurologists, General Physicians and Primary Care Physicians. Neurogenic pulmonary edema can complicate the management of large strokes and cerebral hemorrhage. While the principles of management of this type of pulmonary edema are similar to the more common cardiogenic pulmonary edema, placing a patient in the prone position may be a helpful maneuver facilitating recovery.


METHODS
We describe a case of basilar thrombosis treated with intra-arterial thrombolysis where prone ventilation was employed to treat neurogenic cardio-pulmonary complications.


RESULTS
This resulted in rapid resolution of neurogenic pulmonary edema and patient recovery after recanulation of the basilar artery by intra-arterial urokinase.


CONCLUSIONS
This technique of prone positioning for ventilation is of importance to physicians who manage stroke and its complications.
Marshall
Scott A
SA
Department of Neurosciences Critical Care, The Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA. smarsh15@jhmi.edu
Nyquist
Paul
P
D000328:Adult; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D016684:Prone Position; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000209:etiology; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy
D014568:Urokinase-Type Plasminogen Activator