ECG Changes in 8-Year-Old Boy with Pulmonary Edema after Head Injury

Abstract

This is a case story of an 8-year-old boy with no prior history of cardiac disease who developed acute pulmonary edema with ECG changes similar to transmural myocardial infarction after basilar skull fracture. Biochemical evaluation showed elevated total creatine kinase activity –1,350 U/L with 12% MB isoenzyme fraction. The brain scan on admission showed cerebral edema with ethmoidal sinuses hemorrhage. Neurogenic pulmonary edema following CNS damage is an extremely rare entity in the pediatric population and there are few reports. There are many proposed mechanisms and explanations of its origin. Based on previous reports and experimental studies, the cause of “neurogenic” pulmonary edema may be of cardiac as well as of noncardiac origin.

Neurogenic pulmonary edema in an infant with ventriculoperitoneal shunt malfunction

“…Patients who survive the initial insult usually have a rapid cardiopulmonary recovery without late onset morbidity [5,6]. NPE and NSM are rare in children but have been reported with trauma [7][8][9][10][11], hemorrhage [12][13][14][15][16], seizure [17], tumor-related obstructive hydrocephalus [4,18], viral encephalitis [19][20][21][22], ketamine toxicity [23], and following decompression of Chiari malformations [24]. Johnson et al [4] reported two cases of NSM and pulmonary edema secondary to acute hydrocephalus.…”