Neurogenic stunned myocardium after acute hydrocephalus.
Neurogenic stunned myocardium (NSM) is a syndrome of cardiac stunning after a neurological insult. It is commonly observed after aneurysmal subarachnoid hemorrhage but is increasingly being reported after other neurological events. The underlying mechanism of NSM is believed to be a hypothalamic-mediated sympathetic surge causing weakened cardiac contractility and even direct cardiac myocyte damage. The authors report 2 cases of NSM in pediatric patients after acute hydrocephalus. Both patients experienced severe cardiac dysfunction in the acute phase but ultimately had a good neurological outcome and a full cardiac recovery. The identification, treatment, and outcome in 2 rare pediatric cases of NSM are discussed, and the history of the brain-cardiac connection is reviewed.
Johnson
Jeremiah
J
Division of Pediatric Neurosurgery, University of Miami Miller School of Medicine, Lois Pope Life Center, 1095 NW 14th Terrace, Miami, Florida 33136, USA. jjohnson22@med.miami.edu
Ragheb
John
J
Garg
Ruchira
R
Patten
William
W
Sandberg
David I
DI
Bhatia
Sanjiv
S
D000293:Adolescent; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002528:Cerebellar Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002535:Cerebral Aqueduct / Q000503:physiopathology / Q000601:surgery; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D006321:Heart / Q000294:innervation*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D007031:Hypothalamus / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008527:Medulloblastoma / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017682:Myocardial Stunning / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D003336:Tectum Mesencephali / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D014696:Ventriculostomy