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Takotsubo syndrome linked to paroxysmal sympathetic hyperactivity as a postoperative complication after brain tumor removal: a case report and literature review

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A Correction to this article was published on 16 May 2024

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Abstract

Paroxysmal sympathetic hyperactivity (PSH) is a relatively common syndrome typically observed following traumatic brain injury (TBI). It manifests through a combination of non-specific symptoms that collectively define its presentation. Linked to sympathetic hyperactivity, takotsubo syndrome is a cardiomyopathy marked by left ventricular dysfunction and may coincide with PSH. While various factors can lead to the simultaneous occurrence of these syndromes, a notably rare scenario involves their manifestation after brain tumor removal. The nonspecific nature of PSH symptoms and of the cardiac dysfunction in takotsubo syndrome pose challenges in accurately diagnosing these conditions in an intensive care unit (ICU) setting. They often overlap with more prevalent diagnoses like sepsis, pulmonary embolism, and acute heart failure. Thus, it is crucial for clinicians dealing with these patients to be aware that symptoms indicating sympathetic activity surge and left heart failure might prompt consideration of takotsubo syndrome and PSH. This study presents the case of an 8-year-old girl who developed takotsubo syndrome associated with sympathetic hyperactivity following the surgical removal of a bulbar tumor. To the best of our knowledge, this is the tenth case of PSH following brain tumor removal in a pediatric patient and the first reported case of occurrence of takotsubo linked to PSH after brain tumor removal. We offer a detailed account of the patient’s clinical journey in the ICU, accompanied by a comprehensive review of relevant literature to identify similar cases. The significance of this case study lies in emphasizing the potential occurrence of takotsubo syndrome due to PSH and underscores the importance of early diagnosis and management due to their association with unfavorable clinical outcomes.

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Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, La Timone Hospital, Aix-Marseille University, Marseille, France

    Manel Krouma, A. Aboudou Soilihi, Gregoire Pech-Gourg & Didier Scavarda

  2. Department of Pediatric Anesthesiology and Intensive Care, La Timone Hospital, Aix-Marseille University, Marseille, France

    Sophie Arnaud & Marco Caruselli

  3. Department of Pediatric and Congenital Cardiology, La Timone Hospital, Aix-Marseille University, Marseille, France

    El Louali Fadoua

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  1. Manel Krouma
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Contributions

Authorship responsibilities were distributed as follows: MK, GPG, and DS played key roles in conceptualization, data compilation, methodology establishment, and manuscript composition. AS, SA, CM, and ELF participated in data gathering and provided guidance throughout the research endeavor.

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Correspondence to Didier Scavarda.

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The original online version of this article was revised: In this article the author name "Marco Caruselli" was incorrectly written as "Caruselli Marco".

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Krouma, M., Aboudou Soilihi, A., Pech-Gourg, G. et al. Takotsubo syndrome linked to paroxysmal sympathetic hyperactivity as a postoperative complication after brain tumor removal: a case report and literature review. Childs Nerv Syst (2024). https://doi.org/10.1007/s00381-024-06316-9

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