What question did this study set out to answer?

To examine the evidence surrounding intracranial triggers of Takotsubo syndrome and their implications.

January 10, 2026Journal of Neurosurgical Anesthesiology0 citations

Intracranial Triggers of Takotsubo Syndrome

Q: What does this research mean for the field?

Intracranial events are significant triggers of Takotsubo syndrome, with a 10.9% recurrence rate and higher mortality associated with subarachnoid hemorrhage. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

BSBruna Bastiani dos SantosHospital de Clínicas Universidade Federal do Paraná LPLuis F. Fabrini PalearePontifícia Universidade Católica do Paraná FSFelipe SalvagniHospital Universitário Evangélico de Curitiba

Key Result

Intracranial events were significant triggers of Takotsubo syndrome, with a 10.9% recurrence rate and higher mortality associated with subarachnoid hemorrhage.

Key Points

To examine the evidence surrounding intracranial triggers of Takotsubo syndrome and their implications.
Conducted a systematic review following PRISMA guidelines.
Included case reports of Takotsubo syndrome triggered by intracranial events.
Analyzed outcomes such as complications and recurrence rates.
Included 167 studies with 156 conventional TTS patients and 28 with reverse TTS.
Common complications were arrhythmias (39.4%) and pulmonary edema (15.1%).
Most patients showed favorable outcomes, but mortality was higher in cases triggered by subarachnoid hemorrhage.

Structured PICO

What are the clinical characteristics, complications, and outcomes of Takotsubo syndrome triggered by intracranial events?

Population

184 patients (156 with conventional Takotsubo syndrome and 28 with reverse Takotsubo syndrome) pooled from 167 case reports, mean age 57.73 years, 85.9% female.

Intervention

Intracranial events acting as triggers (including seizures, subarachnoid hemorrhage, ischemic stroke, multiple sclerosis, traumatic brain injury, and tumor removal).

Outcome

TTS-associated complications, cardiomyopathy status at last follow-up, and recurrence rates.hard clinical

Intracranial events, particularly seizures and subarachnoid hemorrhage, are significant triggers for Takotsubo syndrome, which generally has favorable outcomes but carries a higher mortality risk when precipitated by subarachnoid hemorrhage.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Introduction: Takotsubo syndrome (TTS) is a transient left ventricular dysfunction triggered by stress, often associated with intracranial disorders. This review examines intracranial triggers of TTS, summarizing evidence and implications. Methods: We searched PubMed and Web of Science following PRISMA guidelines. Eligible studies included case reports of TTS precipitated by intracranial events. Outcomes analyzed included TTS-associated complications, cardiomyopathy status at last follow-up, and recurrence rates. Subgroup analyses were performed based on trigger type and for the reverse TTS (rTTS). Results: A total of 167 studies were included, comprising 156 patients with conventional TTS and 28 with rTTS. The mean age in the conventional cohort was 57.73 years, with 85.9% being female. Hypertension (16.5%) was the most common comorbidity. ST-segment elevation (45.1%) and T-wave inversion (38.2%) were predominant electrocardiographic findings, while left ventricular systolic dysfunction (65.2%) was the main echocardiographic abnormality. Complications occurred in 95 patients, most commonly arrhythmias (39.4%), pulmonary edema (15.1%), and new valve disorders (11.2%). At last follow-up, 134 cases resolved, 15 patients died, and recurrence was 10.9%. Triggers were: seizures (n=43), subarachnoid hemorrhage (SAH) (n=36), ischemic stroke (n=18), multiple sclerosis (n=6), traumatic brain injury (n=6), tumor removal (n=6), and others (n=30). Conclusion: Intracranial events are significant TTS triggers. While outcomes are favorable, mortality was more common in patients with SAH compared with other triggers. Standardized studies are needed to optimize treatment. Given that all included studies were case reports, findings should be interpreted cautiously, recognizing the exploratory nature of the data and the limitations in the level of evidence.

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