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June 6, 2026NMC Case Report JournalOpen Access

Delayed-onset Neurogenic Pulmonary Edema Following a Ruptured Posterior Communicating Artery Aneurysm: A Case Report

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Key result

Fluid restriction and diuretics rapidly improve delayed neurogenic pulmonary edema after subarachnoid hemorrhage.

  • n=1

Why the study?

Neurogenic pulmonary edema typically presents with immediate onset following acute central nervous system injury, making delayed-onset cases uncommon.

Population

One 68-year-old man with subarachnoid hemorrhage from a ruptured left posterior communicating artery aneurysm

Design

Case report

Authors

SFS FukamiHamamatsu University School of MedicineYKYoshinobu KamioHamamatsu University School of MedicineHNHiroaki NekiHamamatsu University School of Medicine

Discussion

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Implication

Documents delayed neurogenic pulmonary edema at 96 hours after subarachnoid hemorrhage; hypothesis-generating and leaves open the need for larger studies before changing monitoring practices.

Key Points

  • This report aims to describe a rare case of delayed-onset neurogenic pulmonary edema following a ruptured aneurysm.
  • Case report of a 68-year-old man post-subarachnoid hemorrhage due to aneurysm rupture.
  • Diagnosis confirmed through clinical assessment and echocardiography to exclude cardiogenic causes.
  • Management involved fluid restriction and diuretic therapy, followed by successful aneurysm coil embolization.
  • Patient developed tachypnea and hypoxemia 96 hours post-symptom onset, diagnosed with neurogenic pulmonary edema.
  • Echocardiography results were normal, ruling out heart-related causes.
  • Patient improved rapidly with targeted therapies, emphasizing the importance of timely management.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
A 68-year-old man with subarachnoid hemorrhage who developed delayed-onset neurogenic pulmonary edema 96 hours after symptom onset.
I
Intervention
Fluid restriction and diuretic therapy, followed by aneurysm coil embolization
O
Outcome
Clinical improvement of pulmonary edema and successful aneurysm treatment

Delayed neurogenic pulmonary edema can occur several days after subarachnoid hemorrhage, highlighting the need for clinicians to consider this diagnosis when respiratory deterioration occurs late.

Limitations

  • Single case report
  • Pathophysiology of delayed presentation remains speculative

Cite This Study

Fukami et al. (2026) conducted a case report in Subarachnoid hemorrhage and delayed-onset neurogenic pulmonary edema (n=1). Fluid restriction and diuretic therapy was evaluated on Clinical improvement of pulmonary edema. A 68-year-old man with subarachnoid hemorrhage developed delayed neurogenic pulmonary edema 96 hours after onset, which rapidly improved with fluid restriction and diuretic therapy.

synapsesocial.com/papers/6a23b89f71a5da9775e74cddhttps://doi.org/10.2176/jns-nmc.2025-0413
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Neurogenic pulmonary edema after subarachnoid hemorrhage: a case report2019
  2. 2Neurogenic Pulmonary Edema Caused by Subarachnoid Hemorrhage: A Case Report2021
  3. 3Neurogenic Pulmonary Edema Associated with Ruptured Intracranial Aneurysm: Case Report1986 · 36 citations
  4. 4Neurogenic pulmonary edema following intracranial coil embolization for subarachnoid hemorrhage -A case report-2012 · 5 citations
  5. 5Massive Flash Neurogenic Pulmonary Edema after Subarachnoid Hemorrhage2024