Out-of-hospital cardiac arrest from neurologic cause: recognition and outcome*

In a minority of cases, neurologic injury precedes and causes cardiac arrest (CA). This occurs when CA is due to a neurologic cause—usually, a neurovascular accident, such as ischemic stroke, subarachnoid hemorrhage (SAH), or intracerebral hemorrhage. The pathophysiology and clinical course of CA due to neurologic causes are much less studied than those of CA due to primary cardiac or respiratory causes, partly because of its less common occurrence and partly because these cases are often overlooked. In fact, during CA, neurological examination is of limited value and there is often little information on preceding symptoms. Furthermore, acute cerebrovascular events may induce electrocardiogram (ECG) changes, such as ST elevation, which mimic those of acute coronary syndromes.