Neurogenic Pulmonary Edema Caused by Subarachnoid Hemorrhage: A Case Report

Neurogenic pulmonary edema is a serious and life-threatening complication caused by central nervous system diseases, excluding cardiogenic pulmonary edema, other causes of pulmonary edema, lung injury, etc. The lack of specific diagnostic criteria for NPE and the lack of awareness among clinicians often lead to underdiagnosis and misdiagnosis. The disease progresses rapidly with poor prognosis and high mortality [1]. In this paper, we report a patient with a ruptured right middle cerebral artery aneurysm causing subarachnoid hemorrhage, who developed neurogenic pulmonary edema and underwent elective aneurysm clamping under general anesthesia. The relevant perioperative management is reported as follows, and the anesthesia management of patients with neurogenic pulmonary edema is analyzed in the context of the relevant literature.

De novo aneurysm formation after the contralateral middle cerebral aneurysm clipping operation: a case report and review of literature

A left middle cerebral artery aneurysm was ruptured and clipped, but a de novo aneurysm on contralateral side ruptured within 5 years in a 38-year-old man. The cause of the formation of de novo aneurysms is unknown and is not consistent with most of current reports.

P.189 Unruptured Posterior Cerebral Artery aneurysm causing temporal lobe epilepsy

Background: Cerebral aneurysms are an unusal cause of epilepsy. To date, several groups have reported temporal lobe seizures caused by aneurysms projecting into the parahippocampal gyrus. Given the low incidence of posterior cerebral artery aneurysms, they are a very rare cause of temporal lobe seizures. Methods: Here, we report a rare case of temporal lobe epilepsy caused by an unruptured aneurysm. We also present a review of the literature yielding two similar cases. Results: A previosuly well 56 year old male presented to a neurologist with symptoms consistent with temporal lobe epilepsy. He was started on carbamzepine and underwent imaging and neuropsychological assessments. An MRI suggested the existance of a 7mm posterior cerebral artery aneurysm arising from the P2 segment of the posterior cerebral artery and projecting into the parahippocampal gyrus. This was also confirmed with CT angiography and the patient elected to have the aneurysm clipped. Conclusions: Temporal lobe epilepsy is an uncommon presentation for unruptured cerebral aneurysms. We report a rare case wherein a laterally pointing PCA aneurysm was buried in the posterior parahippocampal gyrus. This aneurysm had caused perifocal gliosis leading to stereotyped seizures. Post-operatively, the patient has been seizure free.