A 26-year-old Woman With Sudden Onset Cerebral Edema

Claffey report a case of a 26-year-old woman with a sudden onset cerebral edema. Approximately two hours after arrival at the emergency department, the woman's mental status deteriorated. She became unresponsive to painful stimuli and had a Glasgow Coma Scale score of 3, requiring endotracheal intubation. The patient's course of treatment included normal saline solution infusion at a rate of 125 mL per hour and 30 g of intravenous mannitol every six hours, yet she showed no signs of neurologic improvement. She continued to experience significant serum electrolyte disturbances and progressed to renal failure. Forty-eight hours after ED presentation, a cerebral perfusion study documented no blood flow, and she was declared brain dead. Mechanical ventilation was discontinued on day 3.