Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage
Joint Authors
Jolly, Suneil
Pokala, Krishna
Liu, Yan
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-02-11
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Paroxysmal sympathetic storming (PSS) is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis.
It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage.
Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH), there is no descriptive report of PSS primarily caused by spontaneous SAH up to date.
Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm.
The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks.
In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH.
In this case, vasospasm might be a precipitating factor.
Paralytics and hypothermia could mask the manifestations of PSS.
The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.
American Psychological Association (APA)
Liu, Yan& Jolly, Suneil& Pokala, Krishna. 2013. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage. Case Reports in Medicine،Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-465591
Modern Language Association (MLA)
Liu, Yan…[et al.]. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage. Case Reports in Medicine No. 2013 (2013), pp.1-4.
https://search.emarefa.net/detail/BIM-465591
American Medical Association (AMA)
Liu, Yan& Jolly, Suneil& Pokala, Krishna. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage. Case Reports in Medicine. 2013. Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-465591
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-465591