Neurogenic pulmonary edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic pulmonary edema, one with head injury and other with intracerebral hemorrhage Diagnosis was made by rapid onset of pulmonary edema, severe hypoxemia, decrease of pulmonary complacence and diffuse pulmonary infiltrations, without previous history of tracheal aspiration or any other risk factor for developement of adult respiratory distress syndrom In the first case, with severe head trauma, neurogenic pulmonary edema was diagnosed at admission one hour after trauma, associated with severe systemic inflammatory reaction. and good outcome in three days. The second case, with hemorragic vascular insult, developed neurogenic pulmonary edema the fourth day after drenage of intracerebral hematom and died.552305309Bembridge, M., Madej, T.H., Neurogenic pulmonary oedema (1985) Anaesthesia, 40, pp. 202-204Braude, N., Ludgrove, T., Neurogenic pulmonary oedema precipitated by induction of anaesthesia (1989) Br J Anaesth, 62, pp. 101-103Brito, J.C.F., Diniz, M.C.A., Rosas, R.R., Silva, J.A.G., Edema pulmonar agudo neurogênico relato de caso (1995) Arq Neuropsiquiatr, 53, pp. 288-293Brown, R.H., Beyerl, B.D., Iseke, R., Lavy, M.H., Medulla oblongata oedema associated with neurogenic pulmonary oedema: Case report (1986) J Neurosurg, 64, pp. 494-500Casey, W.F., Neurogenic pulmonary oedema (1983) Anaesthesia, 38, pp. 985-988Dettbarn, C.L., Davidson, L.J., Pulmonary complications in the patient with acute head injury: Neurogenic pulmonary oedema (1989) Heart Lung, 18, pp. 583-589Ell, S.R., Neurogenic pulmonary oedema, a review of the literature and a perspective (1991) Inv Radiol, 26, pp. 499-506Falcão, A.L.E., Dantas, V.F., Sardinha, L.C., Quagliato, E.A.B., Diagosavac, D., Araújo, S., Terzi, R.G.G., Highlighting intracranial pressure monitoring in patients with severe acute brain trauma (1995) Arq Neuropsiquiatr, 53, pp. 390-394Falcão, A.L.E., Dantas, V.F., Saraiva, J.F.K., Sardinha, L.C., Araújo, S., Terzi, R.G.G., Bedside ICP monitoring in head trauma patients by using a simple. safe and low cost metodology (1992) Clin Int Care, 3 (SUPPL.), p. 112Graf, C.J., Rossi, N.P., Pulmonary oedema and central nervous system.A clinico-pathological study (1975) Surg Neurol, 4, pp. 319-325Kauffman, H.H., Timberlake, G., Voelker, J., Glenn, P.T., Medical complications of head injury (1993) Med Clin North Am Jan, 70, pp. 43-60Knudsen, F., Jensen, H.P., Peterson, P.L., Neurogenic pulmonary edema treatment with dobutamine (1991) Neurosurgery, 29, pp. 269-270Li, C., Gefter, W.B., Acute pulmonary edema induced by overdosage of phenothiazines (1992) Chest, 101, pp. 102-104Malik, A.B., Mechanisms of neurogenic pulmonary edema (1985) Circ Res, 57, pp. 1-18Melone, E., Bonnet, F., Lepreslo, E., Fevrier, M.J., Djindjian, M., Francois, Y., Gray, F., Debras, C., Altered capillary permeability in neurogenic pulmonary edema (1985) Int Care Med, 11, pp. 323-325Murphy, P.G., Jackson, R., Kirollos, R., Gibson, J.S., Chennells, P., Adult respiratory distress syndrome after attenuated strangulation (1993) Br J Anasth, 70, pp. 583-586Pender, E.S., Pollack, C.V., Neurogenic pulmonary edema: Case reports and review (1992) J Em Med, 10, pp. 45-51Pollack, V., Pollack, E.S., Neurogenic pulmonary edema (1993) J Emerg Med, 11, pp. 207-210Simmons, R.L., Martin, A.M., Heisterkamp, C.A., Ducher, T.B., Respiratory insufficiency in combat casualties. II Pulmonary edema following head injury (1969) Ann Surg, 170, pp. 39-41Simon, R.P., Neurogenic pulmonary edema (1993) Neurol Clin, 11, pp. 309-323Simon, R.P., Medullary lesion inducing pulmonary edema a magnetic resonance imaging study (1991) Ann Neurol, 30, pp. 727-730Toucho, H., Kavasawa, J., Sishido, H., Yamada, K., Yamazaki, Y., Neurogenic pulmonary edema in the acute stage of hemorrhagic cerebrovascular disease (1989) Neurosurgery, 25, pp. 762-768Wauchob, T.D., Brooks, R.J., Harrison, K.M., Neurogenic pulmonary oedema (1984) Anaesthesia, 39, pp. 529-534Wright, R.S., Feuerman, T., Brown, J., Neurogenic pulmonary edema after trigeminal nerve blockade (1989) Chest, 96, pp. 436-438