Neurogenic stunned myocardium after acute hydrocephalus.

[hydrocephalus with stenosis of the aqueduct of sylvius]

Neurogenic stunned myocardium (NSM ) is a syndrome of cardiac stunning after a neurological insult . It is commonly observed after aneurysmal subarachnoid hemorrhage but is increasingly being reported after other neurological events . The underlying mechanism of NSM is believed to be a hypothalamic -mediated sympathetic surge causing weakened cardiac contractility and even direct cardiac myocyte damage . The authors report 2 cases of NSM in pediatric patients after acute hydrocephalus . Both patients experienced severe cardiac dysfunction in the acute phase but ultimately had a good neurological outcome and a full cardiac recovery . The identification , treatment , and outcome in 2 rare pediatric cases of NSM are discussed , and the history of the brain -cardiac connection is reviewed .