II Klinika Neurologiczna, Instytut Psychiatrii i Neurologii w Warszawie, ul. Sobieskiego 9, 02-957 Warszawa.
Neurol Neurochir Pol. 2009 Nov-Dec;43(6):570-4.
Acute lung injury (ALI), including acute respiratory distress syndrome (ARDS), is a critical condition consisting of acute hypoxaemic respiratory failure with bilateral pulmonary infiltrates of non-cardiogenic origin. Occasionally it develops in patients with acute or subacute central nervous system pathologies, such as increased intracranial pressure and brain stem lesions. The exact epidemiology of neurogenic pulmonary oedema is unknown. However, due to non-specific clinical manifestation it often remains undiagnosed. Its pathogenesis probably involves overactivation of the sympathetic autonomic system with pulmonary hypertension and increased vessel permeability. We present a case of successfully managed ARDS in a previously healthy patient with newly diagnosed and symptomatic haemangioblastoma of the medulla oblongata. In this context we also review current knowledge on the aetiopathogenesis, diagnostic criteria and treatment for neurogenic ARDS.
急性肺损伤(ALI),包括急性呼吸窘迫综合征(ARDS),是一种以急性低氧性呼吸衰竭为特征的危重症,其双肺浸润源于非心源性病因。偶尔,它会在伴有急性或亚急性中枢神经系统疾病的患者中发展,例如颅内压增高和脑干病变。神经源性肺水肿的确切流行病学尚不清楚。然而,由于其临床表现不具特异性,该疾病往往未被诊断。其发病机制可能涉及交感自主神经系统的过度激活,伴有肺动脉高压和血管通透性增加。我们报告了一例此前健康的患者发生 ARDS 的病例,该患者患有新诊断的延髓血管母细胞瘤,且伴有症状。在此背景下,我们还回顾了神经源性 ARDS 的病因发病机制、诊断标准和治疗的最新知识。