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Korean J Crit Care Med > Volume 25(2); 2010 > Article
Korean Journal of Critical Care Medicine 2010;25(2): 93-97. doi: https://doi.org/10.4266/kjccm.2010.25.2.93
뇌동맥류 파열 후 발생한 신경성 기절심근과 폐부종 -증례 보고-
성균관대학교 의과대학 강북삼성병원 마취통증의학교실, *신경외과학교실, †한림대학교 의과대학 한강성심병원 마취통증의학교실
Neurogenic-stunned Myocardium and Pulmonary Edema Following a Ruptured Cerebral Aneurysm: A Case Report
Sung Ha Mun, Won Joon Choi, Jeong Min Mok, Jae Young Yang, Chul Ho Woo
1Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. anesmun@hanmail.net
2Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
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.
Key Words: aspiration pneumonia; neurogenic pulmonary edema; stunned myocardium
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