title: Takotsubo cardiomyopathy - An unexpected complication in spine surgery.
abstract: BACKGROUND
  Takotsubo cardiomyopathy is an apical ballooning syndrome, which can be triggered by stress. Only few case reports describe the onset of Takotsubo as a complication of neurosurgery procedures.
  
  
  METHODS
  A case of a 53 year-old female with a spinal neurinoma and surgery-associated Takotsubo cardiomyopathy is demonstrated. The patient developed typical signs of a myocardial infarction with circulation depression and ST elevation, but normal cardiac enzymes at the end of surgery. Cardiac catheterization and levocardiography confirmed the absence of any critical coronary disease but the presence of a typical apical ballooning and midventricular hypokinesis. The patient recovered completely under supportive conservative and cardiological therapy, showing regular left ventricular pump function.
  
  
  CONCLUSIONS
  Interventions in neurosurgery and perioperative care should be kept as stress free as possible. Due to the possibility of neurogenic mechanisms related to cardiomyopathy, Takotsubo cardiomyopathy as an entity of stress-induced complications should be taken into consideration.
authors.affiliation: Institute of Anatomy, University of Leipzig, Liebigstraße 13, D-04103 Leipzig, Germany. Electronic address: niels.hammer@medizin.uni-leipzig.de.
authors.forename: Niels
authors.initials: N
authors.lastname: Hammer
authors.affiliation: Department of Neuroradiology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kühne
authors.affiliation: Department of Neurosurgery, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Meixensberger
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hänsel
authors.affiliation: Department of Neurosurgery, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany. Electronic address: dirk.winkler@medizin.uni-leipzig.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Winkler
keywords: Apical ballooning; Neurinoma; Stress-free surgery; Takotsubo cardiomyopathy