The Pattern of Brain Microhemorrhages After Severe Lung Failure Resembles the One Seen in High-Altitude Cerebral Edema

Crit Care Med. 2015 Sep;43(9):e386-9. doi: 10.1097/CCM.0000000000001150.


Objectives: After suffering from severe acute respiratory distress syndrome, several patients show generalized brain alterations and atrophy. A distinctive morphologic pattern of cerebral injury, however, has not been found so far.

Data sources: We present the history of three patients who survived severe acute respiratory distress syndrome. In these patients, MRI of the brain showed multiple microhemorrhages predominantly in the splenium of the corpus callosum. An identical pattern of microhemorrhages has previously been described in mountaineers who suffered from high-altitude cerebral edema.

Conclusions: This report demonstrates that patients after treatment for acute respiratory distress syndrome and high-altitude cerebral edema show congruent cerebral injuries. Further investigation into the similarities of the causative conditions and neurologic consequences might reveal underlying pathophysiologic mechanisms and clinical implications of this observation.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Altitude Sickness / pathology*
  • Brain / physiopathology
  • Brain Edema / pathology*
  • Corpus Callosum / pathology*
  • Female
  • Hemorrhage / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Respiratory Distress Syndrome / pathology*
  • Respiratory Insufficiency