Document Detail


Large cerebellar hemorrhage during trumpet playing: importance of blood pressure elevation during the valsalva maneuver: case report.
MedLine Citation:
PMID:  18824959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors report a case of a large intracerebellar hemorrhage that occurred in a professional musician while playing the trumpet. This is the first report of such a complication. CLINICAL PRESENTATION: A 60-year-old man presented with severe occipital headache accompanied by nausea, vomiting, and dizziness that occurred while he was practicing the trumpet. On presentation, he was hypertensive with a systolic blood pressure of 255 mmHg and was found to have a large left cerebellar hemorrhage. INTERVENTION: Magnetic resonance imaging and magnetic resonance angiography were performed but revealed no tumor or vascular abnormality. The patient was initially stable but, despite maximal medical therapy, deteriorated and was taken to the operating room for suboccipital craniectomy and evacuation of the hematoma. CONCLUSION: This patient likely had chronic hypertension; however, the transient increase in systolic blood pressure associated with intensive trumpet playing and the Valsalva maneuver may have contributed to his risk of hemorrhage. We suggest that hypertensive screening and therapy may be especially important in this population and emphasize the importance for neurosurgeons to understand the physiology involved in the Valsalva maneuver.
Authors:
Andrew P Carlson; Suguna Pappu; Marcus F Keep; Paul Turner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  62     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-09-30     Completed Date:  2008-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1377; discussion E1377     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA.
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MeSH Terms
Descriptor/Qualifier:
Cerebellum*
Humans
Intracranial Hemorrhages / etiology*
Intracranial Hypertension / etiology*,  physiopathology
Male
Middle Aged
Music*
Valsalva Maneuver / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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