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Updated: May 7, 2026
06:18
A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
[BNP elevation due to a subdural hematoma - misled by a biomarker].
1Klinik für Kardiologie, Klinikum Oldenburg gGmbH.
Deutsche Medizinische Wochenschrift (1946)
|September 26, 2013
Summary
Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with atypical symptoms may indicate neurological causes, such as subdural hematoma, not solely cardiac issues. Prompt diagnosis and intervention are crucial for improved outcomes.
Area of Science:
- Cardiology
- Neurology
- Internal Medicine
Background:
- A 73-year-old male with a mechanical aortic valve and heart failure presented with a reduced general condition.
- Initial examination revealed normal age-related findings, mechanical valve sounds, and a systolic murmur.
Observation:
- Elevated inflammatory markers (leukocytosis, CRP), anemia, and supratherapeutic digitoxin levels were noted.
- High N-terminal pro-B-type natriuretic peptide (NT-proBNP) prompted cardiac investigation, which was inconclusive.
- Despite initial treatment, the patient's condition worsened, with rising NT-proBNP and disorientation.
Findings:
- A history of a fall revealed a large chronic subdural hematoma on CT scan.
- The subdural hematoma was identified as the cause of the elevated NT-proBNP.
- Successful surgical intervention for the subdural hematoma was performed.
Implications:
- This case highlights the importance of considering neurological causes in patients with elevated BNP and atypical symptoms.
- Subdural hematomas can mimic cardiac conditions by causing elevated NT-proBNP.
- Comprehensive diagnostic evaluation is essential for accurate diagnosis and effective treatment.
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