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

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著者

    • INAMASU Joji
    • Department of Neurosurgery, Fujita Health University School of Medicine
    • SUGIMOTO Keiko
    • Department of Loborotory Medicine, Fujita Health University School of Medicine
    • HAYASHI Takuro
    • Department of Neurosurgery, Fujita Health University School of Medicine
    • KATO Yoko
    • Department of Neurosurgery, Fujita Health University School of Medicine
    • HIROSE Yuichi
    • Department of Neurosurgery, Fujita Health University School of Medicine

抄録

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.<br>

収録刊行物

  • Neurologia medico-chirurgica = 神経外科

    Neurologia medico-chirurgica = 神経外科 52(2), 49-55, 2012-02-15

    The Japan Neurosurgical Society

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各種コード

  • NII論文ID(NAID)
    10030127182
  • NII書誌ID(NCID)
    AN00358613
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    04708105
  • データ提供元
    CJP書誌  J-STAGE 
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