Cardiac abnormalities in patients with acute subdural hemorrhage

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Katharina M Busl1, Mahesh Raju, Bichun Ouyang

  • 1Section of Neurocritical Care, Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB Suite 1121, Chicago, IL, 60612, USA, katharina_busl@rush.edu.

Neurocritical Care
|July 31, 2013
PubMed

Insights

Cardiac abnormalities are common in acute subdural hemorrhage (SDH) patients but not linked to SDH severity. Myocardial injury is infrequent, suggesting non-neurogenic causes require consideration for better management.

Area of Science:

  • Neuroscience
  • Cardiology
  • Critical Care Medicine

Background:

  • Cardiac abnormalities are well-documented in acute brain injury but understudied in acute subdural hemorrhage (SDH).
  • Systematic investigation of cardiac issues in SDH patients is lacking.

Purpose of the Study:

  • To determine the prevalence and characteristics of cardiac abnormalities in patients with acute subdural hemorrhage.
  • To explore the association between cardiac abnormalities and SDH characteristics.

Main Methods:

  • Analysis of consecutive adult patients with SDH admitted to a Neurosciences Intensive Care Unit.
  • Review of electrocardiograms (ECGs) obtained within 48 hours of admission.
  • Identification of myocardial injury via troponin I elevation (>0.09 ng/ml).

Main Results:

  • 75% of 114 SDH patients exhibited ECG abnormalities; myocardial injury (elevated troponin) occurred in 9 patients.
  • Cardiac abnormalities were not associated with SDH characteristics (size, midline shift).
  • Classic neurogenic ECG findings were not observed.

Conclusions:

  • ECG abnormalities are frequent in SDH but not linked to SDH severity, and classic neurogenic findings are absent.
  • Myocardial injury is infrequent and not associated with SDH characteristics.
  • Non-neurocardiogenic mechanisms are likely more prominent in SDH, necessitating consideration of other medical causes for management.
Abstract

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