%0 Journal Article
%T Challenges of Management of Stunned Myocardium Associated with Acute Subarachnoid Hemorrhage: A Case Report
%A Dewan Md Elyas
%A Kazi Mohibur Rahman
%A Khairul Kabir Patwary
%A Md Aminul Hasanat
%A Md Badrul Alam
%A Sharif Uddin Khan
%A Sirajee Shafiqul Islam
%A Uzzwal Kumar Mallick
%J Journal of National Institute of Neurosciences Bangladesh
%D 2018
%R https://doi.org/10.3329/jninb.v4i2.38932
%X A 40 year old lady presented with headache and vomiting having no past history of hyper-tension, diabetes, smoking, alcohol or drug abuse. Computed Tomography (CT) scan of brain revealed sub-arachnoid haemorrhage in parasaggital frontal and lt. Sylvian fissure. Digital Subtraction Angiogram (DSA) was performed and revealed a small aneurysm (4x 2.5 x 2) mm in anterior communicating artery. After 12 hours of DSA patient complaints of sudden severe headache followed by unconsciousness. Repeat CT performed and revealed new onset rt. fronto-basal intra-cranial hematoma consistent with rebleed. On admission the patient was with normal Glasgow Coma Scale (GCS-15), Blood pressure (BP125/80mm/Hg), ECG & Echocardiogram. After rebleed patient developed low BP (50/35mmHg), GCS down gread (05), ECG showed sinus tachycardia with poor progression of R(V1-V3) wave, elevated cardiac Troponin ¨CI(-4919.6 Pg). Then patient was given a regimen of ionotropic agent noradrenalin at dose 5mcg/kg/h. From day 3th of rebleed the patient was clinically improving, BP(120/84mmHg), GCS( 8), ECG normal, Cardiac Troponin-I- (790.8 Pg/dl). Then emergency endovascular ACOM coil embolization was done. Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 150-153
%K Sub-arachnoid hemorrhage
%K Stunned myocardium
%K aneurysm
%K coil embolization
%U https://www.banglajol.info/index.php/JNINB/article/view/38932