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[Cardiac disease in intracerebral hematomas]
V Serrano-Castro1, A Gil-Peralta, J R González-Marcos
1Servicio de Neurologia, Hospital Universitario Virgen del Rocio, Sevilla, España.
Revista De Neurologia
|June 23, 1998
Summary
Intracerebral hemorrhage can cause cardiac arrhythmias, with right-sided bleeds linked to supraventricular arrhythmias and left-sided bleeds potentially associated with sudden death. Continuous cardiac monitoring is recommended for patients with brain hematomas.
Area of Science:
- Neurology
- Cardiology
- Medical Research
Background:
- The central nervous system (CNS) significantly regulates cardiac function.
- CNS lesions, particularly intracerebral hemorrhages, are linked to ECG abnormalities like QT interval prolongation and arrhythmias, sometimes leading to sudden death.
- Autonomic nervous system imbalance, favoring sympathetic activity, is a proposed mechanism.
Purpose of the Study:
- To investigate cardiac changes in patients with non-severe intracerebral hemorrhage.
- To assess the impact of hematoma location (left vs. right hemisphere) and patient history (hypertension, heart disease) on ECG findings.
- To explore the relationship between intracerebral hemorrhage and cardiac arrhythmias.
Main Methods:
- A study involving 32 inpatients with non-severe intracerebral hemorrhage.
- Holter ECG monitoring was performed within 72 hours of hemorrhage and again after two months.
- ECG findings were analyzed concerning hematoma location and pre-existing cardiovascular conditions.
Main Results:
- 69.2% of patients exhibited ECG changes, and 73% had rhythm abnormalities.
- Supraventricular arrhythmias, specifically atrial extrasystoles, were significantly more common with right-hemisphere hematomas.
- No significant differences in ECG findings were observed based on a history of hypertension or heart disease.
- Two cases of sudden death occurred, both associated with left-hemisphere hematomas.
Conclusions:
- Right hemispheric hematomas are more frequently associated with supraventricular arrhythmias.
- Left hemispheric hematomas may be linked to severe ventricular arrhythmias and sudden death, warranting further investigation in larger cohorts.
- Continuous cardiac monitoring is advised for acute intracerebral hemorrhage cases.