| Intra-aortic balloon pump counterpulsation in the setting of subarachnoid hemorrhage, cerebral vasospasm, and neurogenic stress cardiomyopathy. Case report and review of the literature. | |
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MedLine Citation:
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PMID: 20383610 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The management of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) can be often complicated by the presence of stunned myocardium and left ventricular failure. Vasopressors and inotropes are commonly used to optimize mean arterial pressure (MAP) and cerebral perfusion pressure (CPP). Intra-aortic balloon counterpulsation pump (IABP) may be indicated in the management of these patients. METHODS: We report the case of a 55-year-old patient who suffered an aSAH complicated by severe left ventricular failure, who subsequently developed symptomatic cerebral vasospasm. Left ventricular failure precluded traditional hemodynamic augmentation, and IABP was successfully used instead, which allowed for reinstitution of hypertensive hypervolemic therapy and prevented delayed cerebral ischemia. RESULTS: A review of the literature conducted on symptomatic cerebral vasospasm after aSAH and severe left ventricular failure revealed seven publications describing 14 patients with aSAH treated with an IABP during the period of vasospasm. CONCLUSIONS: Intra-aortic balloon counterpulsation pump (IABP) is used for hemodynamic support of patients in cardiogenic shock and its use in the setting of aSAH, cardiomyopathy, and cerebral vasospasm can be beneficial in preventing delayed ischemic deficits. |
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Authors:
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Christos Lazaridis; Gustavo Pradilla; Paul A Nyquist; Rafael J Tamargo |
Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Neurocritical care Volume: 13 ISSN: 1556-0961 ISO Abbreviation: Neurocrit Care Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-05 Completed Date: 2010-10-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 101-8 Citation Subset: IM |
Affiliation:
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Neurosciences Intensive Care Unit, Departments of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA. lazaridi@musc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiomyopathies
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complications*,
etiology Cerebral Angiography Echocardiography Heart Failure / complications, ultrasonography Heart Ventricles Humans Intra-Aortic Balloon Pumping* Intracranial Aneurysm / complications, radiography, surgery Male Middle Aged Myocardial Stunning / complications Shock, Cardiogenic / complications*, therapy* Subarachnoid Hemorrhage / complications*, radiography Tomography, X-Ray Computed Vasospasm, Intracranial / complications*, radiography |
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