뇌동맥류 파열 후 발생한 신경성 기절심근과 폐부종-증례 보고-
Neurogenic-stunned Myocardium and Pulmonary Edema Following a Ruptured Cerebral Aneurysm-A Case Report-
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초록
We report a case of neurogenic cardiopulmonary instability with pulmonary edema occurring after an aneurysmal subarachnoid hemorrhage. The patient`s pre-operative Glasgow coma scale score was 6 and the PA chest radiograph showed increased diffuse haziness in the right lung field. The patient presented with severe hypotension and low oxygen saturation during surgery. Cardiac damage was documented by increased CK-MB troponin-T levels, and ischemic ECG findings. Reversible cardiac failure associated with subarachnoid hemorrhage may be due to a neurogenic- stunned myocardium. The patient underwent clipping of the aneurysm and recovered with minimal neurologic impairment and normal cardiac function.
Abstract
We report a case of neurogenic cardiopulmonary instability with pulmonary edema occurring after an aneurysmal subarachnoid hemorrhage. The patient`s pre-operative Glasgow coma scale score was 6 and the PA chest radiograph showed increased diffuse haziness in the right lung field. The patient presented with severe hypotension and low oxygen saturation during surgery. Cardiac damage was documented by increased CK-MB troponin-T levels, and ischemic ECG findings. Reversible cardiac failure associated with subarachnoid hemorrhage may be due to a neurogenic- stunned myocardium. The patient underwent clipping of the aneurysm and recovered with minimal neurologic impairment and normal cardiac function.
참고문헌 (14)
- Baumann A, "Neurogenic pulmonary edema", Acta Anaesthesiol Scand, 51, pp.447~455 (2007)
- Bahloul M, "Neurogenic pulmonary edema due to traumatic brain injury: evidence of cardiac dysfunction", Am J Crit Care, 15, pp.462~470 (2006)
- Makaryus JN, "Unilateral neurogenic pulmonary oedema and severe left ventricular dysfunction secondary to acute multiple sclerosis exacerbation", Heart Lung Circ, 18, pp.155~158 (2009)
- Simon RP, "Neurogenic pulmonary edema", Neurol Clin, 11, pp.309~323 (1993)
- Sedý J, "Mechanisms of neurogenic pulmonary edema development", Physiol Res, 57, pp.499~506 (2008)
- Tintinalli JE, "American College of Emergency Physicians: Emergency medicine: a comprehensive study guide. 6th ed", pp.2793~ (2004), McGraw-Hill, Medical Pub. Division
- Perrin C, "Unilateral neurogenic pulmonary edema. A case report", Rev Pneumol Clin, 60, pp.43~45 (2004)
- Donaldson JW, "Myocardial stunning secondary to aneurysmal subarachnoid hemorrhage", Surg Neurol, 55, pp.12~16 (2001)
- de Chazal I, "Delayed cardiogenic shock and acute lung injury after aneurysmal subarachnoid hemorrhage", Anesth Analg, 100, pp.1147~1149 (2005)
- 김덕경, "Neurogenic Cardiopulmonary Instability with Pulmonary Edema after a Traumatic Head Injury - A case report -", Korean Journal of Anesthesiology, 53(3), pp.52~57 (2007), 대한마취과학회
- Jain R, "Management of patients with stunned myocardium associated with subarachnoid hemorrhage", AJNR Am J Neuroradiol, 25, pp.126~129 (2004)
- Handlin LR, "Reversible left ventricular dysfunction after subarachnoid hemorrhage", Am Heart J, 126, pp.235~240 (1993)
- Bulsara KR, "Use of the peak troponin value to differentiate myocardial infarction from reversible neurogenic left ventricular dysfunction associated with aneurysmal subarachnoid hemorrhage", J Neurosurg, 98, pp.524~528 (2003)
- Seow VK, "Neurogenic pulmonary oedema misdiagnosed as acute myocardial infarction in a comatose patient", Ann Acad Med Singapore, 36, pp.684~686 (2007)