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Neurocritical Care
Published in: Neurocritical Care 3/2018

01-12-2018 | Practical Pearl

Medulla Oblongata Hemorrhage and Reverse Takotsubo Cardiomyopathy

Authors: Kevin T. Gobeske, Maurice E. Sarano, Jennifer E. Fugate, Eelco F. Wijdicks

Published in: Neurocritical Care | Issue 3/2018

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Abstract

Background

Acute brain injury with strong surges of adrenergic outflow has resulted in takotsubo cardiomyopathy, but there are surprisingly few reports of takotsubo cardiomyopathy after intracranial hemorrhage, and none have been described from hemorrhage within the brainstem.

Results

We describe a patient with reverse and reversible cardiomyopathy following a hemorrhage in the lateral medulla oblongata. While it is limited in size, the location of the hemorrhage caused acute systolic failure with left ventricular ejection fraction of 27% and vasopressor requirement for cardiogenic shock and pulmonary edema. There was full recovery after 7 days.

Methods

Detailed case report.

Conclusion

Hemorrhage into medulla oblongata pressor centers may result in acute, reversible, stress-induced cardiomyopathy, affirming the adrenergic origin of this condition.
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Metadata
Title
Medulla Oblongata Hemorrhage and Reverse Takotsubo Cardiomyopathy
Authors
Kevin T. Gobeske
Maurice E. Sarano
Jennifer E. Fugate
Eelco F. Wijdicks
Publication date
01-12-2018
Publisher
Springer US
Published in
Neurocritical Care / Issue 3/2018
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-017-0482-8

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