Cardiology Department, ASST Nord Milano, Ospedale E. Bassini, Milano, Italy.
Cardiology Department, ASST Nord Milano, Ospedale E. Bassini, Milano, Italy.
J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104308. doi: 10.1016/j.jstrokecerebrovasdis.2019.104308. Epub 2019 Aug 12.
Stroke involving some areas of the cerebral hemisphere, such as insula, amygdala, and lateral hypothalamus, may cause changes in autonomic control of cardiac function. A 58-year-old woman presented to the emergency department for acute onset of left facial-brachial-crural hemiparesis and dysarthria. A brain CT scan showed subacute ischemic lesion with hemorrhagic infarction in right insular-rolandic cortex. Over the next few days ECG showed severe bradycardia with elongation of QTc, significative pauses (5 seconds), runs of nonsustained ventricular tachycardia and torsades de pointes. Drug induced and other several possible causes of elongation of QT and bradycardia such as hypokalemia, a history of heart failure, and structural heart disease were ruled out. The case confirms that insular cortex plays a major role in stroke-induced cardiovascular changes.
涉及大脑半球某些区域的中风，如岛叶、杏仁核和外侧下丘脑，可能导致心脏功能自主控制的变化。一名 58 岁女性因左面部-臂-下肢偏瘫和构音障碍到急诊科就诊。脑 CT 扫描显示右侧岛叶-罗兰多皮质亚急性缺血性病变伴出血性梗死。接下来的几天，心电图显示严重心动过缓伴 QTc 延长，显著停顿（5 秒），非持续性室性心动过速和尖端扭转型室性心动过速发作。排除了 QT 延长和心动过缓的药物诱导和其他几种可能原因，如低钾血症、心力衰竭病史和结构性心脏病。该病例证实，岛叶皮层在中风引起的心血管变化中起着重要作用。
