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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(01): 113-119
DOI: 10.4103/ajns.AJNS_331_19
Original Article

Endovascular therapy for aneurysmal subarachnoid hemorrhage complicated by neurogenic pulmonary edema and takotsubo-like cardiomyopathy: A report of ten cases

Senshu Nonaka
Department of Neurosurgery, Juntendo University Urayasu Hospital, Urayasu, Chiba
,
Hidenori Oishi
1   Department of Neurosurgery, Juntendo University School of Medicine, Tokyo
,
Satoshi Tsutsumi
Department of Neurosurgery, Juntendo University Urayasu Hospital, Urayasu, Chiba
,
Hisato Ishii
Department of Neurosurgery, Juntendo University Urayasu Hospital, Urayasu, Chiba
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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.

Key-words:

Aneurysmal subarachnoid - endovascular therapy - hemorrhage - neurogenic - pulmonary edema - Takotsubo-like cardiomyopathy

Financial support and sponsorship

Nil.




Publication History

Received: 08 November 2019

Accepted: 16 January 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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