Neurogenic stress cardiomyopathy (tako-tsubo cardiomyopathy) can occur in very elderly patients following good-grade subarachnoid hemorrhage and can be successfully managed with supportive care.
A 90-year-old woman presented with aneurysmal subarachnoid hemorrhage (SAH) corresponding to Hunt and Hess grade II. Acute congestive heart failure and pulmonary edema developed following uneventful surgical clipping. Serial electrocardiography and echocardiography led to a diagnosis of neurogenic stress cardiomyopathy (NSC), also known as tako-tsubo cardiomyopathy. The outcome was favorable after supportive therapy with respiratory management and diuretic administration. Neurosurgeons treating SAH must take into account the various general treatment strategy options on a case by case basis after prompt recognition of NSC.
Yokota et al. (Sat,) studied this question.