These agents may be used to treat concomitant systematic hypertension, if present, but avoid significant hypotension that can diminish cerebral perfusion. Consult a critical-care medicine specialist for ongoing intensive care. Consult a neurosurgeon or neurologist for the evaluation and management of any underlying precipitating event. The combination of NPE and a neurologic insult severe enough to cause NPE always warrants admission to hospital. Intensive care admission may be required if the patient develops increasingly severe hypoxemia, respiratory distress, or if invasive monitoring is required.
Prognosis is determined by the course of any underlying neurological problems.
Suspect NPE when pulmonary edema occurs in an appropriate setting. The characteristic features of NPE are dyspnea, hypoxemia, and radiographic pulmonary infiltrates developing within a few hours of the neurological event. Experimental neurogenic pulmonary edema. The role of systemic hypertension. Acute pulmonary edema as a terminal event in certain forms of epilepsy.