Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Anesthesiol. 2012 Oct;63(4):368-71. doi: 10.4097/kjae.2012.63.4.368. Epub 2012 Oct 12.
Neurogenic pulmonary edema (NPE) is a well-known complication of acute central neurologic injury, particularly aneurysmal subarachnoid hemorrhage. Both increased intracranial pressure and severe over-activation of the sympathetic nervous system seem to be pathogenetic for the onset of NPE. Although intracranial endovascular therapy is minimally invasive, it may affect brain stem regions and result in sympathetic activation. We now report the case of a 70-year-old woman who suddenly developed pulmonary edema during coil embolization of a ruptured aneurysm. During the intervention, oxygen saturation declined suddenly and a chest radiograph revealed pulmonary edema. The delayed appearance of NPE in this patient implies a risk for sympathetically mediated NPE during endovascular therapy.
神经原性肺水肿（NPE）是急性中枢神经系统损伤的一种众所周知的并发症，特别是蛛网膜下腔出血的动脉瘤。颅内压增高和交感神经过度兴奋似乎都是 NPE 发病的发病机制。尽管颅内血管内治疗具有微创性，但它可能会影响脑干区域并导致交感神经激活。我们现在报告一例 70 岁女性在破裂动脉瘤的线圈栓塞过程中突然发生肺水肿的病例。在介入过程中，氧饱和度突然下降，胸部 X 光片显示肺水肿。该患者 NPE 的迟发表现提示血管内治疗期间存在交感神经介导的 NPE 风险。
