Association between electrocardiographic abnormalities and intracranial blood in patients following acute subarachnoid hemorrhage.

The etiological factors that influence the development of electrocardiographic (ECG) abnormalities following a subarachnoid hemorrhage are not fully understood. The purpose of this study was to assess if there was an association between ECG abnormalities and the amount of intracranial blood seen on computerized tomographic (CT) scanning following an acute bleed in patients with a cerebral aneurysm. The charts of 70 patients who had had a preoperative CT scan and a preoperative ECG within 96 h of bleed were reviewed. The neurological status of the patients was graded according to the Botterell classification and the amount of blood seen on the CT scan was graded by the Fisher classification. Thirty patients had an abnormal ECG. Seventy percent of these abnormalities involved the T wave or the ST segment. The incidence of ECG abnormalities was statistically greater for patients who had an increased amount of intracranial blood or an intracerebral clot, as seen on CT scan. All patients had treatment (surgical n = 69, embolization n = 1) of the aneurysm. Neither the amount of blood seen on CT scan nor the incidence of ECG abnormalities was useful in predicting patient outcome. In conclusion, an increased quantity of intracranial blood was associated with an increased incidence of ECG abnormalities.