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

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.

journal_name

Eur Neurol

journal_title

European neurology

authors

Strittmatter M,Meyer S,Fischer C,Georg T,Schmitz B

doi

10.1159/000070856

keywords:

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

30-8

issue

1

eissn

0014-3022

issn

1421-9913

pii

70856

journal_volume

50

pub_type

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