• Scott A Marshall and Paul Nyquist.
• Department of Neurosciences Critical Care, The Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA. smarsh15@jhmi.edu
• Neurocrit Care. 2009 Jan 1; 10 (2): 213-7.

IntroductionStroke is the third most common cause of death in the Western World and is a condition seen by Neurologists, General Physicians and Primary Care Physicians. Neurogenic pulmonary edema can complicate the management of large strokes and cerebral hemorrhage. While the principles of management of this type of pulmonary edema are similar to the more common cardiogenic pulmonary edema, placing a patient in the prone position may be a helpful maneuver facilitating recovery.MethodsWe describe a case of basilar thrombosis treated with intra-arterial thrombolysis where prone ventilation was employed to treat neurogenic cardio-pulmonary complications.ResultsThis resulted in rapid resolution of neurogenic pulmonary edema and patient recovery after recanulation of the basilar artery by intra-arterial urokinase.ConclusionThis technique of prone positioning for ventilation is of importance to physicians who manage stroke and its complications.

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