ABSTRACT
The most common electrocardiogram (ECG) morphologic abnormalities in the central nervous system (CNS) disorders involve ventricular repolarization in the form of elevated or depressed ST segment, flat or inverted T waves, prolonged QT interval, and prominent U waves. The pathologic effects of cardiovascular disorders on the brain are being delineated; the concept of cerebrogenic cardiac injury is being appreciated. Burch described the classical cerebrovascular accident (CVA-T) pattern and suggested a possible brain–heart connection as early as 1954. Over the years, these changes in the CVA-T pattern have been noticed in a gamut of neurologic conditions, for example, ischemic stroke, intracranial hemorrhage, head trauma, neurosurgical procedures, acute meningitis, intracranial space-occupying tumors, limbic encephalitis, multiple sclerosis, and epilepsy. Electrocardiographic changes are observed in almost 42" of patients with brainstem tumors and 56" with supratentorial tumors. Morphologic and rhythm disturbances occur intraoperatively during neurosurgical procedures consequent to cranial nerve stimulation, brainstem manipulation or enhanced sympathetic outflow.
