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Aneurysmal Subarachnoid Hemorrhage Presenting as Cardiorespiratory Arrest

Aneurysmal Subarachnoid Hemorrhage Presenting as Cardiorespiratory Arrest Abstract • Three cases of subarachnoid hemorrhage (SAH) due to ruptured developmental (berry) aneurysm are reported. Two patients presented with cardiac arrest and were successfully resuscitated, but the diagnosis of SAH was delayed and this most likely influenced poor final outcome. The third patient presented with irreversible respiratory arrest. The possible mechanisms responsible for SAH-triggered cardiac arrhythmia and/or respiratory arrest are discussed. Absence of previous cardiac history, persistent headache, focal neurologic findings (especially papilledema or subhyaloid hemorrhages) should warn the clinician of the possibility of SAH and warrant further neurologic investigation. (Arch Intern Med 1987;147:1661-1662) References 1. Byer E, Ashman R, Toth LA: Electrocardiograms with large, upright T-waves and long Q-T intervals. Am Heart J 1947;33:796-906.Crossref 2. Cropp GJ, Manning GW: Electrocardiographic changes simulating myocardial ischemia and infarction associated with spontaneous intracranial hemorrhage. Circulation 1960;22:25-38.Crossref 3. Shuster S: The electrocardiogram in subarachnoid haemorrhage. Br Heart J 1960;22:316-320.Crossref 4. Hersch C: Electrocardiographic changes in subarachnoid haemorrhage, meningitis, and intracranial space-occupying lesions. Br Heart J 1964;26:785-793.Crossref 5. Srivastava SC, Robson AO: Electrocardiographic abnormalities associated with subarachnoid haemorrhage. Lancet 1964;2:431-433.Crossref 6. Abildskov JA, Millar K, Burgess MJ, et al: The electrocardiogram and the central nervous system. Prog Cardiovasc Dis 1970;13:210-216.Crossref 7. Weintraub BM, McHenry LC Jr: Cardiac abnormalities in subarachnoid hemorrhage: A resume. Stroke 1974;5:384-392.Crossref 8. Eisalo A, Perasalo J, Halonen PI: Electrocardiographic abnormalities and some laboratory findings in patients with subarachnoid haemorrhage. Br Heart J 1972;34:217-226.Crossref 9. Estanol BV, Marin OSM: Cardiac arrhythmias and sudden death in subarachnoid hemorrhage. Stroke 1975;6:382-386.Crossref 10. Grossman MA: Cardiac arrhythmias in acute central nervous system disease. Arch Intern Med 1976;136:203-207.Crossref 11. Parizel G: On the mechanism of sudden death with subarachnoid hemorrhage. J Neurol 1979;220:71-76.Crossref 12. Adams HP Jr, Jergenson DD, Kassell NF, et al: Pitfalls in the recognition of subarachnoid hemorrhage. JAMA 1980;244:794-796.Crossref 13. Adams HP Jr, Kassell NF, Kongable G, et al: Atypical features of subarachnoid hemorrhage, abstracted. Ann Neurol 1985;18:123. 14. Wolf S: The end of the rope: The role of the brain in cardiac death. Can Med Assoc J 1967:97:1022-1025. 15. Greenhoot JH, Reichenbach DD: Cardiac injury and subarachnoid hemorrhage: A clinical, pathological, and physiological correlation. J Neurosurg 1969;30:521-531.Crossref 16. Talman WT, Alonso DR, Reis DJ: Chronic lability of arterial pressure in the rat does not evolve into hypertension. Clin Sci 1980;59:405s-407s. 17. Hijdra A, van Gijn J: Early death from rupture of an intracranial aneurysm. J Neurosurg 1982;57:765-768.Crossref 18. Hijdra A, Vermeulen M, van Gijn J, et al: Respiratory arrest in subarachnoid hemorrhage. Neurology 1984;34:1501-1503.Crossref 19. Bass E: Cardiopulmonary arrest: Pathophysiology and neurologic complications. Ann Intern Med 1985;103:920-927.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Aneurysmal Subarachnoid Hemorrhage Presenting as Cardiorespiratory Arrest

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1987.00370090137022
Publisher site
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Abstract

Abstract • Three cases of subarachnoid hemorrhage (SAH) due to ruptured developmental (berry) aneurysm are reported. Two patients presented with cardiac arrest and were successfully resuscitated, but the diagnosis of SAH was delayed and this most likely influenced poor final outcome. The third patient presented with irreversible respiratory arrest. The possible mechanisms responsible for SAH-triggered cardiac arrhythmia and/or respiratory arrest are discussed. Absence of previous cardiac history, persistent headache, focal neurologic findings (especially papilledema or subhyaloid hemorrhages) should warn the clinician of the possibility of SAH and warrant further neurologic investigation. (Arch Intern Med 1987;147:1661-1662) References 1. Byer E, Ashman R, Toth LA: Electrocardiograms with large, upright T-waves and long Q-T intervals. Am Heart J 1947;33:796-906.Crossref 2. Cropp GJ, Manning GW: Electrocardiographic changes simulating myocardial ischemia and infarction associated with spontaneous intracranial hemorrhage. Circulation 1960;22:25-38.Crossref 3. Shuster S: The electrocardiogram in subarachnoid haemorrhage. Br Heart J 1960;22:316-320.Crossref 4. Hersch C: Electrocardiographic changes in subarachnoid haemorrhage, meningitis, and intracranial space-occupying lesions. Br Heart J 1964;26:785-793.Crossref 5. Srivastava SC, Robson AO: Electrocardiographic abnormalities associated with subarachnoid haemorrhage. Lancet 1964;2:431-433.Crossref 6. Abildskov JA, Millar K, Burgess MJ, et al: The electrocardiogram and the central nervous system. Prog Cardiovasc Dis 1970;13:210-216.Crossref 7. Weintraub BM, McHenry LC Jr: Cardiac abnormalities in subarachnoid hemorrhage: A resume. Stroke 1974;5:384-392.Crossref 8. Eisalo A, Perasalo J, Halonen PI: Electrocardiographic abnormalities and some laboratory findings in patients with subarachnoid haemorrhage. Br Heart J 1972;34:217-226.Crossref 9. Estanol BV, Marin OSM: Cardiac arrhythmias and sudden death in subarachnoid hemorrhage. Stroke 1975;6:382-386.Crossref 10. Grossman MA: Cardiac arrhythmias in acute central nervous system disease. Arch Intern Med 1976;136:203-207.Crossref 11. Parizel G: On the mechanism of sudden death with subarachnoid hemorrhage. J Neurol 1979;220:71-76.Crossref 12. Adams HP Jr, Jergenson DD, Kassell NF, et al: Pitfalls in the recognition of subarachnoid hemorrhage. JAMA 1980;244:794-796.Crossref 13. Adams HP Jr, Kassell NF, Kongable G, et al: Atypical features of subarachnoid hemorrhage, abstracted. Ann Neurol 1985;18:123. 14. Wolf S: The end of the rope: The role of the brain in cardiac death. Can Med Assoc J 1967:97:1022-1025. 15. Greenhoot JH, Reichenbach DD: Cardiac injury and subarachnoid hemorrhage: A clinical, pathological, and physiological correlation. J Neurosurg 1969;30:521-531.Crossref 16. Talman WT, Alonso DR, Reis DJ: Chronic lability of arterial pressure in the rat does not evolve into hypertension. Clin Sci 1980;59:405s-407s. 17. Hijdra A, van Gijn J: Early death from rupture of an intracranial aneurysm. J Neurosurg 1982;57:765-768.Crossref 18. Hijdra A, Vermeulen M, van Gijn J, et al: Respiratory arrest in subarachnoid hemorrhage. Neurology 1984;34:1501-1503.Crossref 19. Bass E: Cardiopulmonary arrest: Pathophysiology and neurologic complications. Ann Intern Med 1985;103:920-927.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Sep 1, 1987

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