Neurogenic pulmonary oedema due to brain death

Case contributed by Stefan Tigges
Diagnosis almost certain

Presentation

Found down.

Patient Data

Age: 25 years
Gender: Female
Frontal
Frontal
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Endotracheal tube appropriately positioned, bilateral perihilar opacities compatible with pulmonary oedema.

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Extensive subarachnoid haemorrhage. Loss of gray-white differentiation, effaced gyri and sulci. Recent external ventricular drain placement with intraventricular air.

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Preserved external carotid blood flow, but no intracranial blood flow within either the internal carotids or basilar artery.

Nuclear medicine
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Cerebral perfusion study shows no intracranial radiotracer uptake.

Case Discussion

This patient experienced a subarachnoid haemorrhage due to a ruptured anterior communicating artery aneurysm which resulted in increased intracranial pressure and brain death. Neurogenic pulmonary oedema is occasionally present in cases of fatal subarachnoid haemorrhage.

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