Neurogenic Stunned Myocardium Associated with Acute Spinal Cord Infarction: A Case Report

Introduction. Neurogenic stunned myocardium (NSM) is a reversible cardiomyopathy resulting in transient left ventricular apical ballooning presumed to result from catecholamine surge occurring under physiologic stress. Acute spinal cord ischemia is a rare ischemic vascular lesion. We report a case of neurogenic stunned myocardium occurring in the setting of acute spinal cord infarction.Methods. Singe case report was used.Results. We present the case of a 63-year-old female with a history of prior lacunar stroke, hypertension, chronic back pain, and hypothyroidism who presented with a brief episode of diffuse abdominal and bilateral lower extremity pain which progressed within minutes to bilateral lower extremity flaccid paralysis. MRI of the spinal cord revealed central signal hyperintensity of T2-weighted imaging from conus to T8 region, concerning for acute spinal cord ischemia. Transthoracic echocardiogram was performed to determine if a cardiac embolic phenomenon may have precipitated this ischemic event and showed left ventricular apical hypokinesis and ballooning concerning for NSM.Conclusion. Neurogenic stunned myocardium is a reversible cardiomyopathy which has been described in patients with physiologic stress resulting in ventricular apical ballooning. Our case suggests that it is possible for neurogenic stunned myocardium to occur in the setting of acute spinal cord ischemia.

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Stress-induced cardiomyopathy in aneurysmal subarachnoid hemorrhage

Acta chirurgica iugoslavica ◽

10.2298/aci1701069n ◽

2017 ◽

Vol 64 (1) ◽

pp. 69-71

Author(s):

Tijana Nastasovic ◽

Branko Milakovic ◽

Mila Stosic ◽

Milos Kaludjerovic ◽

Olga Petrovic ◽

...

Keyword(s):

Mechanical Ventilation ◽

Acute Coronary Syndrome ◽

Case Report ◽

Subarachnoid Hemorrhage ◽

Takotsubo Cardiomyopathy ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Apical Ballooning ◽

Stunned Myocardium ◽

Coronary Syndrome ◽

Neurogenic Stunned Myocardium

Introduction: Neurogenic stunned myocardium is well described after aneurysmal subarachnoid hemorrhage. Stress-induced cardiomyopathy (takotsubo cardiomyopathy) is a form of neurogenic stunned myocardium which is not common after subarachnoid hemorrhage. We describe a case report of stress-induced cardiomyopathy (takotsubo cardiomyopathy) after aneurysmal subarachnoid hemorrhage. Case report: A previously healthy postmenopausal woman suffered aneurysmal subarachnoid hemorrhage with consequent hydrocephalus. After external ventricular drainage, craniotomy and aneurysm of the posterior inferior cerebellar artery clipping, patient developed signs of acute coronary syndrome with heart failure. Transthoracic echocardiogram showed left ventricular apical ballooning and hypercontractile basal segments. On chest radiography bilateral pulmonary infiltrates were seen. Mechanical ventilation and continuous sedation were started. Five days after, patient was weaned from mechanical ventilation and extubated. On control echocardiogram, the signs of apical ballooning syndrome resolved. Conclusions: This case and review of the literature suggest stress-induced cardiomyopathy can mimic acute coronary syndrome after aneurysmal subarachnoid hemorrhage.

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A rare case of transient left ventricular apical ballooning syndrome following living donor liver transplantation: A case report and literature review

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2019.02.002 ◽

2019 ◽

Vol 55 ◽

pp. 218-222

Author(s):

Asuka Tanaka ◽

Takashi Onoe ◽

Kohei Ishiyama ◽

Kentaro Ide ◽

Hirotaka Tashiro ◽

...

Keyword(s):

Liver Transplantation ◽

Case Report ◽

Living Donor ◽

Rare Case ◽

Living Donor Liver Transplantation ◽

Apical Ballooning ◽

Left Ventricular ◽

Apical Ballooning Syndrome ◽

Donor Liver ◽

Donor Liver Transplantation

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Incomplete Tetraplegia Resulting from Cervical Spinal Cord Infarction of Unknown Etiology: A Case Report

PM&R ◽

10.1016/j.pmrj.2013.08.495 ◽

2013 ◽

Vol 5 ◽

pp. S282-S282

Author(s):

Lailah C. Issac ◽

Henry S. York ◽

Peter Gorman

Keyword(s):

Spinal Cord ◽

Case Report ◽

Cervical Spinal Cord ◽

Unknown Etiology ◽

Spinal Cord Infarction

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EXTENSIVE SPINAL CORD INFARCTION AFTER POSTERIOR FOSSA SURGERY IN THE SITTING POSITION: CASE REPORT

Neurosurgery ◽

10.1227/01.neu.0000125008.93625.5e ◽

2004 ◽

Vol 54 (6) ◽

pp. 1512-1516 ◽

Cited By ~ 26

Author(s):

Xavier Morandi ◽

Laurent Riffaud ◽

Seyed F.A. Amlashi ◽

Gilles Brassier

Keyword(s):

Spinal Cord ◽

Case Report ◽

Posterior Fossa ◽

Spinal Cord Infarction ◽

Posterior Fossa Surgery ◽

Sitting Position

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Bilateral lower extremity hyperkeratotic plaques: a case report of ichthyosis vulgaris

Clinical Cosmetic and Investigational Dermatology ◽

10.2147/ccid.s89871 ◽

2015 ◽

pp. 485 ◽

Cited By ~ 2

Author(s):

Hayley Leight ◽

Zachary Zinn ◽

Omid Jalali

Keyword(s):

Case Report ◽

Lower Extremity ◽

Bilateral Lower Extremity ◽

Ichthyosis Vulgaris

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Myelopathy in sickle cell disease: a case-oriented review

10.5327/1516-3180.563 ◽

2021 ◽

Author(s):

Igor Vilela Brum ◽

Guilherme Diogo Silva ◽

Diego Sant'Ana Sodre ◽

Felipe Melo Nogueira ◽

Samira Luisa dos Apostolos Pereira ◽

...

Keyword(s):

Spinal Cord ◽

Case Report ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Case Reports ◽

Spinal Cord Infarction ◽

Sensory Level ◽

Cell Disease ◽

Hematopoietic Tissue ◽

First Case

Background: Although neurological complications are well recognized in sickle cell disease (SCD), myelopathy has been rarely described. We present the first case report of longitudinally extensive myelitis (LETM) in SCD and review the differential diagnosis of myelopathy in these patients. Design and setting: case-oriented review. Methods: We report the case of a 29-year-old African-Brazilian man with SCD, who experienced a subacute flaccid paraparesis, with T2 sensory level and urinary retention. CSF analysis showed a lymphocytic pleocytosis and increased protein levels. MRI disclosed a longitudinally extensive spinal cord lesion, with a high T2/STIR signal extending from C2 to T12. Serum anti-aquaporin-4 antibody was negative. We searched Medline/ PubMed, Embase, Scopus, and Google Scholar databases for myelopathy in SCD patients. Results: Spinal cord compression by vertebral fractures, extramedullary hematopoietic tissue, and Salmonella epidural abscess have been reported in SCD. We found only three case reports of spinal cord infarction, which is unexpectedly infrequent compared to the prevalence of cerebral infarction in SCD. We found only one case report of varicella-zoster myelitis and no previous report of LETM in SCD patients. Conclusion: Specific and time-sensitive causes of myelopathy should be considered in SCD patients. In addition to compression and ischemia, LETM should be considered as a possible mechanism of spinal cord involvement in SCD.

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