Document Detail

Intra-aortic balloon pump counterpulsation in the setting of subarachnoid hemorrhage, cerebral vasospasm, and neurogenic stress cardiomyopathy. Case report and review of the literature.
MedLine Citation:
PMID:  20383610     Owner:  NLM     Status:  MEDLINE    
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.
Christos Lazaridis; Gustavo Pradilla; Paul A Nyquist; Rafael J Tamargo
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Neurocritical care     Volume:  13     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  101-8     Citation Subset:  IM    
Neurosciences Intensive Care Unit, Departments of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA.
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MeSH Terms
Cardiomyopathies / complications*,  etiology
Cerebral Angiography
Heart Failure / complications,  ultrasonography
Heart Ventricles
Intra-Aortic Balloon Pumping*
Intracranial Aneurysm / complications,  radiography,  surgery
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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