Abstract
Introduction
Neurogenic cardiopulmonary complications associated with acute brain injury other then subarachnoid hemorrhage were seldom reported, especially in the pediatric population. We report a child who developed cardiac arrhythmia, severe myocardial injury and neurogenic pulmonary edema after cerebellar hemorrhage.
Methods and results
An 11-year-old girl had abrupt onset of spontaneous cerebellar hemorrhage presented with a fulminant picture of hypertension, supraventricular tachyarrhythmia, markedly elevated cardiac enzyme (troponin-I > 50 ng/ml), and acute pulmonary edema. The cardiopulmonary complications were deemed neurogenic because of their rapid onset after brain injury and exclusion of external blunt chest injury, resuscitative injury, and risks for underlying cardiac disease.
Conclusions
In addition to SAH, severe neurogenic cardiopulmonary complications could develop in pediatric patients with cerebellar hemorrhage. Supraventricular tachycardia may be an uncommon presenting rhythm that warrants considering cerebral etiology in patients without apparent cardiac risk.
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References
Dettbarn CL, Davidson LJ. Pulmonary complications in the patient with acute head injury: neurogenic pulmonary edema. Heart Lung 1989;18:583–9.
Solenski NJ, Haley EC Jr, Kassell NF, Kongable G, Germanson T, Truskowski L, et’al. Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the Multicenter Cooperative Aneurysm Study. Crit Care Med 1995;23:1007–17.
van der Kleij FG, Henselmans JM, van de Loosdrecht AA. Cardiac arrhythmia as initial presentation of aneurysmal subarachnoid hemorrhage. Neth J Med 1999;55:242–6.
Randell T, Tanskanen P, Scheinin M, Kytta J, Ohman J, Lindgren L. QT dispersion after subarachnoid hemorrhage. J Neurosurg Anesthesiol 1999;11:163–6.
Masuda T, Sato K, Yamamoto S, et’al. Sympathetic nervous activity and myocardial damage immediately after subarachnoid hemorrhage in a unique animal model. Stroke 2002;33:1671–6.
Lambert E, Du XJ, Percy E, Lambert G. Cardiac response to norepinephrine and sympathetic nerve stimulation following experimental subarachnoid hemorrhage. J Neurol Sci 2002;198:43–50.
Svigelj V, Grad A, Tekavcic I, Kiauta T. Cardiac arrhythmia associated with reversible damage to insula in a patients with subarachnoid hemorrhage. Stroke 1994;25:1053–5.
Stober T, Sen S, Anstatt T, Bette L. Correlation of cardiac arrhythmias with brainstem compression in patients with intracerebral hemorrhage. Stroke 1988;19:688–92.
Novak V, Novak P, deMarchie M, Schondorf R. The effect of severe brainstem injury on heart rate and blood pressure oscillations. Clin Auton Res 1995;5:24–30.
Zaroff JG, Rordorf GA, Titus JS, Newell JB, Nowak NJ, Torchiana DF, Aretz HT, Picard MH, Macdonald RL. Regional myocardial perfusion after experimental subarachnoid hemorrhage. Stroke 2000;31:1136–43.
Smith WS, Matthay MA. Evidence for a hydrostatic mechanism in human neurogenic pulmonary edema. Chest 1997;111:1326–33.
Deehan SC, Grant IS. Hemodynamic changes in neurogenic pulmonary edema: effect of dobutamine. Intensive Care Med 1996;22:672–6.
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Young, YR., Lee, CC., Sheu, BF. et al. Neurogenic Cardiopulmonary Complications Associated with Spontaneous Cerebellar Hemorrhage. Neurocrit Care 7, 238–240 (2007). https://doi.org/10.1007/s12028-007-0059-z
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DOI: https://doi.org/10.1007/s12028-007-0059-z