Endovascular Therapy for Aneurysmal Subarachnoid Hemorrhage Complicated by Neurogenic Pulmonary Edema and Takotsubo-Like Cardiomyopathy: A Report of Ten Cases

Overview

Journal Asian J Neurosurg

Specialty Neurology

Date 2020 Mar 18

PMID 32181183

Citations 3

Authors

Senshu Nonaka

Hidenori Oishi

Satoshi Tsutsumi

Hisato Ishii

Affiliations

Soon will be listed here.

Abstract

Objective: Patients sustaining aneurysmal subarachnoid hemorrhage (aSAH) can be further complicated by neurogenic pulmonary edema (NPE) and Takotsubo-like cardiomyopathy (TCM) with dismal outcomes. The present study aimed to validate the efficacy of endovascular therapy for patients with aSAH complicated by NPE and TCM.

Materials And Methods: Patients who were diagnosed with aSAH complicated by NPE and TCM and treated by endovascular therapy were retrospectively evaluated.

Results: In the past 5 years, a total of ten female patients with aSAH were also diagnosed with NPE and TCM. Six of the ten were cases with high-grade aSAH (Hunt and Hess Grades IV and V), whereas four were low-grade aSAH (Grades II and III). The locations of ruptured aneurysms were the internal carotid-posterior communicating artery junctional site in five patients, the anterior communicating artery in two, the vertebral artery in two, and the middle cerebral artery in one. These aneurysms were successfully embolized by endovascular therapy without any procedure-associated complications. The clinical outcome measure at 6 months after discharge on the Modified Rankin Scale was found to be 0 in four patients, 1 in two, 3 in one, and 5 in three.

Conclusions: Endovascular therapy can be a feasible, alternative measure for the treatment of patients with high-grade aSAH who also have NPE and TCM.

Citing Articles

Diagnosis and Management of Takotsubo Syndrome in Acute Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Review.

Szanto D, Luteran P, Gal J, Nagy E, Fulesdi B, Molnar C Rev Cardiovasc Med. 2024; 24(6):177.

PMID: 39077518 PMC: 11264119. DOI: 10.31083/j.rcm2406177.

Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage.

Hwang E, Koo J, Lee Y, Song J, Lim Y Acta Neurochir (Wien). 2023; 165(12):3677-3684.

PMID: 37924360 DOI: 10.1007/s00701-023-05824-y.

Outcome of Endovascular-Treated Subarachnoid Bleeding Triggering Pulmonary and Cardiac Takotsubo.

Finsterer J, Scorza C, Fiorini A, Scorza F Asian J Neurosurg. 2020; 15(3):794-795.

PMID: 33145257 PMC: 7591163. DOI: 10.4103/ajns.AJNS_98_20.

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