Postictal neurogenic pulmonary edema during uncal herniation--a case report and literature review

A 13-year-old boy fell off a tree and developed an acute subdural hematoma (SDH) which was treated conservatively because the patient was fully conscious. After a generalized tonic-clonic seizure, he manifested signs of uncal herniation and neurogenic pulmonary edema (NPE). The patient made a good recovery after craniotomy and evacuation of the SDH with intensive pulmonary care. Though rare, uncomplicated postictal NPE in children almost runs a smooth course with favorable outcomes. However, the mortality rate is high in postictal NPE complicating cerebral herniation, and it seems an exception that our patient made a good recovery.