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Subarachnoid Hemorrhage Complicated With Neurogenic Pulmonary Edema and Takotsubo-Like Cardiomyopathy

Neurologia medico-chirurgica, 2012, Vol.52(2), pp.49-55 [Peer Reviewed Journal]

2012 by The Japan Neurosurgical Society ;ISSN: 0470-8105 ;EISSN: 1349-8029 ;DOI: 10.2176/nmc.52.49 ;PMID: 22362283

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Title:
Subarachnoid Hemorrhage Complicated With Neurogenic Pulmonary Edema and Takotsubo-Like Cardiomyopathy
Author: INAMASU, Joji ; NAKATSUKASA, Masashi ; MAYANAGI, Keita ; MIYATAKE, Satoru ; SUGIMOTO, Keiko ; HAYASHI, Takuro ; KATO, Yoko ; HIROSE, Yuichi
Subjects: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aneurysm ; Cardiomyopathy ; Cardiovascular system ; Comorbidity - trends ; Demography ; Edema ; Female ; Humans ; Incidence ; Lung ; Male ; Middle Aged ; neurogenic pulmonary edema ; Neurosurgery ; posterior circulation ; Pulmonary Edema - diagnosis ; Pulmonary Edema - epidemiology ; Pulmonary Edema - physiopathology ; Retrospective Studies ; subarachnoid hemorrhage ; Subarachnoid Hemorrhage - diagnosis ; Subarachnoid Hemorrhage - epidemiology ; Subarachnoid Hemorrhage - physiopathology ; Surgery ; Takotsubo Cardiomyopathy - diagnostic imaging ; Takotsubo Cardiomyopathy - epidemiology ; Takotsubo Cardiomyopathy - physiopathology ; takotsubo-like cardiomyopathy ; Ultrasonography ; Young Adult
Is Part Of: Neurologia medico-chirurgica, 2012, Vol.52(2), pp.49-55
Description: Patients with poor-grade subarachnoid hemorrhage (SAH) are often complicated with acute cardiopulmonary dysfunctions, particularly neurogenic pulmonary edema (NPE) and takotsubo-like cardiomyopathy (TCM). This study retrospectively investigated the incidence, demographics, clinical characteristics, and outcomes of patients with SAH complicated with both NPE and TCM (NPE-TCM). The effects of aneurysm location and other clinical variables on the incidence of NPE-TCM were also investigated. Among 234 SAH patients treated during 5-year period, 16 (7%) presented with NPE, and transthoracic ultrasonography revealed that 14 of these 16 patients (88%) also had TCM. All 14 patients with NPE-TCM had poor-grade SAH (World Federation of Neurosurgical Societies grades IV and V). Ruptured posterior circulation aneurysm was predictive of NPE-TCM, but other clinical variables were not. Eight of the 14 patients with NPE-TCM could undergo treatment for ruptured aneurysm. Long-term outcomes were favorable in 5 of the 8 patients. Grade IV SAH patients had significantly better outcomes than grade V patients. TCM develops frequently in SAH patients presenting with NPE, and transthoracic ultrasonography should be conducted routinely in that population. Patients with ruptured posterior circulation aneurysm may have elevated risk of developing NPE-TCM. Endovascular obliteration of the aneurysm may be preferable to open surgery, but the optimal treatment modality needs to be evaluated further. Considering the limited number of SAH patients complicated with NPE-TCM, a multi-center cooperative study may be required.
Publisher: Japan: The Japan Neurosurgical Society
Language: English
Identifier: ISSN: 0470-8105
EISSN: 1349-8029
DOI: 10.2176/nmc.52.49
PMID: 22362283
Source: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection
DOAJ Directory of Open Access Journals

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Subarachnoid Hemorrhage Complicated With Neurogenic Pulmonary Edema and Takotsubo-Like Cardiomyopathy

2012 by The Japan Neurosurgical Society ;ISSN: 0470-8105 ;EISSN: 1349-8029 ;DOI: 10.2176/nmc.52.49 ;PMID: 22362283

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