Abstract
A non-hypertensive 43-year-old woman suddenly suffered from right hemiplegia, sensory disturbance and headache. On admission, she showed coma and tetraplegia. A chest X-ray revealed pulmonary edema, and her arterial b lood gases demonstrated severe hypoxemia. She was treated with artificial ventilation. A brain CT scan disclosed pontine hemorrhage rupturing into the fourth ventricle. Her echocardiogram displayed no abnormality. The pulmonary edema was improved by the next day, and her chest X-ray became normal on the 3rd day. This case was diagnosed as neurogenic pulmonary edema secondary to potine hemorrhage. We speculate that elevation of the intraventricular pressure and oppression of the medulla oblongata caused neurogonic pulmonary edema. Hypoxemia with pontine hemorrhage should be considered for not only neurogenic hypoventilation but also neurogonic pulmonary edema, and adequate respiratory management must be carried out.
