Cardiac Stunning in Acute Noninsular Ischemic Stroke: An Uncommon But Often Unrecognized Scenario

The negative cardiac outcome in patients with acute stroke remains inconclusive and mixed. No data were reported on neurogenic cardiac insult in patients with acute noninsular ischemic stroke, specifically cerebellar stroke, and its impact on cardiac function.

We reported that 4 patients who were healthy at baseline developed transient cardiac stunning after acute ischemic cerebellar stroke. Patients' electrocardiograms and cardiac enzyme levels were normal, and no cardiac intervention was performed because of the presumed neurogenic cardiac outcome. Their cardiac dysfunction spontaneously returned to normal range within 2 to 3 months, as demonstrated by repeated cardiac magnetic resonance imaging or echocardiography.

Although acute stroke involving the insular cortex is a common cause of cardiac stunning, strokes of other territories, such as cerebellar stroke, as shown in this case series report, can also cause neurogenic cardiac dysfunction and should not be overlooked.