Banuelos Polo A, Temes Richard, Lee Vivien H
Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612-3824, USA.
Neurocrit Care. 2008;9(1):108-11. doi: 10.1007/s12028-008-9103-x.
Neurogenic stunned myocardium is characterized by transient left ventricular systolic dysfunction in the absence of significant obstructive coronary artery disease. Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by transient vasogenic subcortical edema without infarction. Both syndromes are hypothesized to result from sympathetic dysregulation. We report a case of neurogenic-stunned myocardium and RPLS occurring simultaneously in a patient.
Single case report.
We present a 55-year-old woman with a history of hypertension and chronic back pain status post spinal cord stimulator who presented with severe headache, seizure, and confusion associated with acute hypertension. Magnetic resonance imaging (MRI) of the brain revealed bilateral patchy T(2) signal hyperintensity, consistent with RPLS. Transthoracic echocardiogram (TTE) showed regional-wall motion abnormalities in the apical regions, consistent with neurogenic-stunned myocardium. The patient's TTE and MRI abnormalities resolved on follow-up studies.
Neurogenic-stunned myocardium and RPLS are two reversible clinical syndromes that are hypothesized to be a result of sympathetic dysregulation. Our case suggests that these two syndromes may occur together in the same patient.
神经源性 stunned 心肌的特征是在无明显阻塞性冠状动脉疾病的情况下出现短暂的左心室收缩功能障碍。可逆性后部白质脑病综合征（RPLS）的特征是出现无梗死的短暂性血管源性皮质下水肿。两种综合征均被推测是由交感神经调节异常所致。我们报告一例患者同时发生神经源性 stunned 心肌和 RPLS 的病例。
单病例报告。
我们报告一名 55 岁女性，有高血压病史及脊髓刺激器植入术后慢性背痛史，因严重头痛、癫痫发作和与急性高血压相关的意识模糊就诊。脑部磁共振成像（MRI）显示双侧片状 T(2)信号高增强，符合 RPLS。经胸超声心动图（TTE）显示心尖区域节段性室壁运动异常，符合神经源性 stunned 心肌表现。随访研究显示患者的 TTE 和 MRI 异常均消失。
神经源性 stunned 心肌和 RPLS 是两种可逆的临床综合征，推测是交感神经调节异常的结果。我们的病例提示这两种综合征可能在同一患者中同时出现。
