Section Editor: Sandy Cheng-Yu Chen, M.D.
Taipei Medical University Hospital, Taipei, Taiwan
Neurogenic pulmonary edema (NPE) is caused by pulmonary interstitial and alveolar congestion after an acute central nervous system damage and without obvious pulmonary cause. The pathogenesis of NPE is not well known. It has been suggested that increased intracranial pressure (IICP) may stimulate the hypothalamus and the vasomotor centers of medulla, causing sympathetic activation and alterations in pulmonary venous pressure, volume, and capillary permeability, leading to NPE. The combination of hydrocephalus (IICP) and tonsillar herniation, and infarctions (arrows in figure B and C), is likely the cause of NPE (figure A) in this young woman. Her NPE dramatically improved after ventriculoperitoneal shunting.