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