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Location-dependent patterns in cardio-autonomic dysfunction in ischaemic stroke.

M Strittmatter·S Meyer·C Fischer·T Georg·B Schmitz
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Abstract

BACKGROUND AND STUDY PURPOSE: Autonomic nervous system dysfunction is a common complication of acute cerebrovascular disorders. The aim of this study was to investigate a possible location-dependent difference in cardio-autonomic function in patients with ischaemic stroke. PATIENTS AND METHODS: Sympathetic function was prospectively assessed by determining plasma norepinephrine and epinephrine in 19 patients with left-hemisphere (LH), 14 with right-hemisphere (RH) and 6 with brainstem/cerebellar (BS) stroke. Blood pressure, heart rate, cardiac output and transcranial flow velocity in the middle cerebral artery were recorded during the first 5 days after stroke. RESULTS: Stroke caused an initial increase in sympathetic function in all 3 groups with a spontaneous decrease in norepinephrine in LH (p < 0.01) and BS stroke (p < 0.05) only. Norepinephrine was significantly higher in RH than in BS stroke (p < 0.05). The alterations in autonomic function were paralleled by a sustained elevation in cardiovascular parameters mainly in RH stroke. CONCLUSIONS: Plasma catecholamines are feasible in monitoring location-dependent autonomic dysfunction in ischaemic stroke. Hemispheric lateralization in autonomic control should be taken into account in the management of stroke because of an increased susceptibility to cardio-autonomic dysfunction in patients with RH stroke.

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AgedAutonomic Nervous System DiseasesBlood Flow VelocityBlood PressureBrainBrain Stem InfarctionsCardiac OutputCerebellar DiseasesCerebral InfarctionDiffusion Magnetic Resonance ImagingDominance, CerebralEpinephrineFemaleFollow-Up StudiesHeartHeart RateHumansMaleMiddle AgedMiddle Cerebral ArteryMonitoring, PhysiologicNorepinephrineProspective StudiesSympathetic Nervous SystemTomography, X-Ray ComputedUltrasonography, Doppler, TranscranialJournal Article

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M Strittmatter, S Meyer, C Fischer, T Georg, B Schmitz. 2003. Location-dependent patterns in cardio-autonomic dysfunction in ischaemic stroke.. https://doi.org/10.1159/000070856

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