Neurogenic stunned myocardium with ventriculoperitoneal shunt malfunction.

The syndrome of left ventricular dysfunction in patients without obstructive coronary artery disease following central nervous system injury is termed neurogenic stunned myocardium (NSM). It has been described most commonly in association with aneurysmal subarachnoid hemorrhage. Nonspecific electrocardiogram (ECG) abnormalities, elevated troponin I levels, and reversible regional-wall motion abnormalities on echocardiogram are observed1,2. In patients with subarachnoid hemorrhage-related NSM, angiography demonstrates normal coronary arteries and a transient left ventricular dysfunction2. A wide variety of neurologic etiologies may also give rise to NSM. These include but are not limited to intracerebral hemorrhage, ischemic stroke, traumatic brain injury, cerebral infarction, seizures, and metastatic brain tumors. Neurogenic Stunned Myocardium with Ventriculoperitoneal Shunt Malfunction