Mechanisms of disease/hypothesis: neurogenic left ventricular dysfunction and neurogenic pulmonary oedema.
BACKGROUND
Acute onset of cardiovascular dysfunction may be the result of insults to the central nervous and autonomic system. Several cerebral regions (insular cortex, lateral, hypothalamus, and brain stem) have been identified as part of the "central autonomic network". The brain stem plays an integral role in controlling and mediating autonomic tone.


METHODS
Case reports.


RESULTS
These two case reports demonstrate the intimate connectivity between the cardiovascular/pulmonary system and the central nervous system in a 13-year-old girl with occipital angiomatosis, but no history of heart disease who developed profound left ventricular dysfunction and pulmonary oedema following pontine haemorrhage, and in a 5-year-old girl who developed severe pulmonary oedema after suffering from status epilepticus.


CONCLUSIONS
The two case reports suggest that cardiovascular dysfunction secondary to central nervous insults and neurogenic pulmonary oedema are not two separate clinical entities, but may very well encompass two different presentations of central autonomic disturbances.
Meyer
Sascha
S
Department of Paediatric Intensive Care Medicine and Neonatology, University Hospital of Saarland, Homburg, Germany. sascha.meyer@uniklinik-saarland.de
Lindinger
Angelika
A
Löffler
Günther
G
Limbach
Hans-Gerhard
HG
Shamdeen
Mohammed G
MG
Gottschling
Sven
S
Reith
Wolfgang
W
Gortner
Ludwig
L
D000293:Adolescent; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D001933:Brain Stem / Q000098:blood supply / Q000503:physiopathology; D002303:Cardiac Output, Low / Q000503:physiopathology / Q000628:therapy; D002533:Cerebral Angiography; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000294:innervation; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000503:physiopathology; D020300:Intracranial Hemorrhages / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D009415:Nerve Net; D009778:Occipital Lobe / Q000098:blood supply / Q000503:physiopathology; D011654:Pulmonary Edema / Q000503:physiopathology* / Q000628:therapy; D013226:Status Epilepticus / Q000503:physiopathology / Q000628:therapy; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology* / Q000628:therapy