title: Hemorrhagic onset of hemangioblastoma located in the dorsal medulla oblongata presenting with tako-tsubo cardiomyopathy and neurogenic pulmonary edema: a case report.
abstract: Here, we present a case of dorsal medulla oblongata hemangioblastoma with fourth ventricular hemorrhage. A 23-year-old female developed sudden consciousness disturbance, and CT revealed hemorrhage in all cerebral ventricles and a hyperdense mass in the cisterna magna. Although the reddish tumor located in the dorsal medulla oblongata was successfully removed, she suffered from severe tako-tsubo cardiomyopathy (TTC) and neurogenic pulmonary edema (NPE) because of baroreflex failure and damage to the solitary tract nuclei. After intensive care for 12 weeks following surgery, she was discharged without any neurological or radiological deficits. Pathogenesis of TTC/NPE is discussed in this paper.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Gekka
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kazumata
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Motegi
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Terasaka
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
keywords: Baroreflex failure; Hemangioblastoma; Medulla oblongata; Neurogenic pulmonary edema; Solitary tract nucleus; Tako-tsubo cardiomyopathy