Neurogenic stunned myocardium after acute hydrocephalus

J Neurosurg Pediatr. 2010 May;5(5):428-33. doi: 10.3171/2009.11.PEDS09341.

Abstract

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.

MeSH terms

  • Adolescent
  • Brain Stem Neoplasms / complications*
  • Brain Stem Neoplasms / diagnosis
  • Brain Stem Neoplasms / physiopathology
  • Brain Stem Neoplasms / surgery
  • Cerebellar Neoplasms / complications*
  • Cerebellar Neoplasms / diagnosis
  • Cerebellar Neoplasms / physiopathology
  • Cerebellar Neoplasms / surgery
  • Cerebral Aqueduct / physiopathology
  • Cerebral Aqueduct / surgery
  • Child, Preschool
  • Constriction, Pathologic / complications
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / physiopathology
  • Constriction, Pathologic / surgery
  • Decompression, Surgical
  • Female
  • Follow-Up Studies
  • Glioma / complications*
  • Glioma / diagnosis
  • Glioma / physiopathology
  • Glioma / surgery
  • Heart / innervation*
  • Humans
  • Hydrocephalus / complications*
  • Hydrocephalus / diagnosis
  • Hydrocephalus / physiopathology
  • Hydrocephalus / surgery
  • Hypothalamus / physiopathology*
  • Magnetic Resonance Imaging
  • Medulloblastoma / complications*
  • Medulloblastoma / diagnosis
  • Medulloblastoma / physiopathology
  • Medulloblastoma / surgery
  • Myocardial Stunning / diagnosis*
  • Myocardial Stunning / physiopathology
  • Myocardial Stunning / surgery
  • Sympathetic Nervous System / physiopathology*
  • Tectum Mesencephali / physiopathology*
  • Tomography, X-Ray Computed
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery
  • Ventriculostomy