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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stroke is the third leading cause of death in the United States. Stroke survivors often experience medical complications and long-term disability. Disturbances in respiratory system function and complications affecting the respiratory system are common after stroke. The nature of these disorders depends on the severity and site of neurological injury. Alterations in breathing control, respiratory mechanics, and breathing pattern are common and may lead to gas exchange abnormalities or the need for mechanical ventilation. Stroke can lead to sleep disordered breathing such as central or obstructive sleep apnea. Sleep disordered breathing may also play a role in the pathogenesis of cerebral infarction. Venous thromboembolism, swallowing abnormalities, aspiration, and pneumonia are among the most common respiratory complications of stroke. Neurogenic pulmonary edema occurs less often. Close observation of the stroke patient for these potential disturbances, and implementation of prophylactic measures can prevent significant morbidity and mortality.
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PMID:Respiratory complications of stroke. 1608 17

In a patient, admitted for cerebral stroke with right side hemiparesis, an acute episode of dyspnea has developed 6 hours after admission. Based on a finding of fine rales on auscultation and a chest radiogram showing congestion, a diagnosis of pulmonary edema was made. The electrocardiogram and cardiac enzymes were normal. Other routine precipitating factors were excluded, and the acute left heart failure was ascribed to the patient's stroke. Neurogenic pulmonary edema may be a result of a vast range of neurological lesions or conditions, including status epilepticus, head trauma, subdural and subarachnoid hemorrhage, brain tumors, meningitis, multiple sclerosis and ischemic stroke. This condition is probably mediated by the sympathetic system outflow, leading eventually to an increase of left atrial pressure, or to an increase in pulmonary vessel permeability. It is treated conventionally, with diuretics and after-load reduction.
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PMID:[Neurogenic pulmonary edema]. 1835 78

A variety of central nervous system lesions like stroke, subarachnoid haemorrhage, trauma and seizure activity can result in neurogenic pulmonary oedema (NPE). Unilateral neurogenic pulmonary oedema is very rare. There are no reports of unilateral NPE with aneurysmal vasospasm. We present the case of a 55-year-old female who developed respiratory distress with unilateral pulmonary oedema and mild left ventricular dysfunction in the context of postoperative cerebral vasospasm following clipping of ruptured intracranial aneurysm. Neurogenic pulmonary oedema should always be in the differential diagnosis when patients with presumed neurogenic pathology develop respiratory compromise. The diagnosis of unilateral neurogenic pulmonary oedema requires a high index of suspicion. Early initiation of supportive treatment results in good outcome.
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PMID:Unilateral neurogenic pulmonary oedema: An unusual cause for post-operative respiratory dysfunction following clipping of ruptured intracranial aneurysm. 2252 22

Neurogenic pulmonary edema (NPE) is a possible complication of severe central nervous system insult. Its physiopathology is still debated. We report a fatal case of a 55-year-old man who was admitted because of severe head injury. The diagnosis of NPE was considered according to clinical and radiologic findings. Transpulmonary thermodilution study showed decreased stroke volume index and cardiac function index. Indexed extravascular lung water was increased as well as pulmonary vascular permeability index. The impairment of the left ventricular function was confirmed by the echocardiographic study. Our case suggests that NPE imply both cardiac dysfunction and lung injury. Thus, transpulmonary thermodilution can be helpful in managing fluid balance and the choice of vasopressors in patients with life-threatening NPE.
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PMID:Neurogenic pulmonary edema after severe head injury: a transpulmonary thermodilution study. 2557 47

Neurogenic pulmonary oedema (NPO) is a rare clinical syndrome of pulmonary oedema occurring secondary to an insult of the central nervous system (CNS). The exact aetiology of this disorder is unknown. NPO can be fatal and poor awareness and identification of this entity, particularly in terms of misdiagnosis as primary pulmonary or cardiac disease, can result in suboptimal management and outcomes. We describe the presentation and management of a 68-year-old woman with an acute left lateral medullary stroke complicated by pulmonary oedema. The likely aetiology is discussed, and important learning points are highlighted.
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PMID:Neurogenic pulmonary oedema complicating a lateral medullary infarct. 3005 24

Neurogenic pulmonary edema (NPE) following acute stroke is an acute respiratory distress syndrome (ARDS) with clinical characteristics that include acute onset, apparent pulmonary interstitial fluid infiltration and rapid resolution. The pathological process of NPE centers on sympathetic stimulation and fulminant release of catecholamines, which cause contraction of resistance vessels. Elevated systemic resistance forces fluid into pulmonary circulation, while pulmonary circulation overload induces pulmonary capillary pressure that elevates, and in turn damages the alveolar capillary barrier. Damage to the alveolar capillary barrier leads to pulmonary ventilation disorder, blood perfusion disorder and oxygenation disorder. Eventually, NPE will cause post-stroke patients' prognosis to further deteriorate. At present, we lack specific biological diagnostic indicators and a meticulously unified diagnostic criterion, and this results in a situation in which many patients are not recognized quickly and/or diagnosed accurately. There are no drugs that are effective against NPE. Therefore, understanding how to diagnose NPE early by identifying the risk factors and how to apply appropriate treatment to avoid a deteriorating prognosis are important scientific goals. We will elaborate the progress of NPE after acute stroke in terms of its pathophysiological mechanisms, etiology, epidemiology, clinical diagnosis and early prediction, comprehensive treatment strategies, and novel drug development. We also propose our own thinking and prospects regarding NPE.
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PMID:Neurogenic pulmonary edema following acute stroke: The progress and perspective. 3273 37