Dynamics of extravascular pulmonary water and intracranial pressure in patients with ischemic stroke.
The objective of the present study was to examine the relationship among extravascular pulmonary water, intracranial and cerebral perfusion pressure, hemodynamic parameters (eg, cardiac index, system vascular resistance index), and brain stem function during acute ischemic stroke. The subjects were 17 comatose patients with ischemic stroke who were admitted to an intensive care unit. The results revealed an elevation in extravascular lung water in the absence of cardiac dysfunction. The absence of correlation between indices of brain vascular resistance and mean arterial pressure confirmed that a disturbance of cerebral blood flow was present. There was a correlation between auditory-evoked potential parameters and extravascular lung water during the study period. The correlation between auditory-evoked potentials and extravascular lung water may imply that ischemic brainstem injury plays a significant role in the development of increased pulmonary capillary permeability and the elevation of extravascular lung water. Brain stem injury is a cause of noncardiogenic lung edema in comatose patients following acute ischemic stroke.