cerebral T waves

Brain-Heart Interaction (ECG abnormalities)

• Described at least since the 1950’s

• Can occur with any brain problems

  • • 42% of patients with brainstem tumors & 56% of patients with intracerebral tumors

      • Rudehill, et al. 1987

    • 71% of patients with SAH & 57% of patients with intracerebral hemorrhage

      • Gibson, et al. 2012

    • Documented with ischemic strokes

• Theories

  • Altered autonomic tone

  • Vagal response

  • Sympathetic surge producing electrical problems and/or myocardial injury

• ECG

  • Large T wave inversions, especially in the anterolateral leads

  • Termed “cerebral T waves” or “rollercoaster T waves”

  • Prolonged QTc (most common)

  • U-waves

  • ST elevation or depression mimicking STEMI

  • Tachy- or bradydysrhythmias

Reference:

1. Rudehill A, Olsson GL, Sundvist K, et al. ECG abnormalities in patients with subarachnoid haemorrhage and intracranial tumors. J Neruol Neurosurg Psychiatry. 1987. Oct;50(10):1375-81. PMID: 3681317