蛛网膜下腔出血伴神经心源性晕厥。

Subarachnoid hemorrhage with neurocardiogenic stunning.

机构信息

Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA.

出版信息

Rev Cardiovasc Med. 2010 Fall;11(4):254-63. doi: 10.3909/ricm0544.

Abstract

A well-recognized complication of acute neurologic injury from intracranial bleeding is cardiotoxicity with electrocardiographic changes and transient left ventricular dysfunction. The phenomenon, called neurocardiogenic stunning (NCS), occurs in 20% to 30% cases of patients with acute subarachnoid hemorrhage (SAH). In this article, we describe a patient with acute SAH complicated by NCS and use this case to highlight the pathogenesis, diagnostic challenges, and management dilemmas that arise in such patients. We also review conventional surgical and medical treatment and present new therapeutic options for this problem.

摘要

颅内出血引起的急性神经损伤的一种众所周知的并发症是心肌毒性，伴有心电图改变和短暂性左心室功能障碍。这种现象称为神经心源性震（NCS），发生在 20%至 30%的急性蛛网膜下腔出血（SAH）患者中。在本文中，我们描述了一例急性 SAH 并发 NCS 的患者，并以此为例强调了此类患者中出现的发病机制、诊断挑战和治疗困境。我们还回顾了传统的手术和药物治疗，并提出了该问题的新的治疗选择。