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Case Reports in Anesthesiology
Volume 2013, Article ID 482596, 4 pages
http://dx.doi.org/10.1155/2013/482596
Case Report

Myocardial Dysfunction in Acute Traumatic Brain Injury Relieved by Surgical Decompression

1Department of Anesthesiology and Pain Medicine, University of Washington, WA 98104, USA
2Departments of Anesthesiology and Pain Medicine, Neurological Surgery (Adj.), University of Washington, WA 98104, USA
3Departments of Anesthesiology and Pain Medicine, Neurological Surgery (Adj.), Pediatrics (Adj.), and Radiology (Adj.), University of Washington, WA 98104, USA

Received 10 April 2013; Accepted 7 May 2013

Academic Editors: I.-O. Lee, C. C. Lu, M. Marandola, H. Shankar, and D. A. Story

Copyright © 2013 Vijay Krishnamoorthy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Traumatic brain injury (TBI) is a major public health issue and is a leading cause of death in North America. After a primary TBI, secondary brain insults can predispose patients to a worse outcome. One of the earliest secondary insults encountered during the perioperative period is hypotension, which has been directly linked to both mortality and poor disposition after TBI. Despite this, it has been shown that hypotension commonly occurs during surgery for TBI. We present a case of intraoperative hypotension during surgery for TBI, where the use of transthoracic echocardiography had significant diagnostic and therapeutic implications for the management of our patient. We then discuss the issue of cardiac dysfunction after brain injury and the implications that echocardiography may have in the management of this vulnerable patient population.