Takotsubo syndrome (TTS) complicating cerebellar hemorrhage is an extraordinarily rare but catastrophic scenario for anesthesiologists. A 19-year-old woman developed refractory cardiogenic shock where conventional pharmacologic therapy failed, necessitating VA-ECMO. Given the extreme bleeding risk, ECMO was instituted without anticoagulation, successfully stabilizing hemodynamics but later complicated by femoral artery thrombosis post-decannulation. Multidisciplinary consensus prioritized neurologic recovery before vascular intervention, ultimately leading to full consciousness and successful staged thrombectomy.
This landmark case underscores the delicate balance between hemorrhagic protection and thrombotic risk in high-stakes ECMO decision-making. To dive into the full case and multidisciplinary strategy, click here to read the journal article. Would you consider…
