Electrocardiographic Changes in Head Injuries

THE electrocardiographic pattern of 164 patieuts with head injury was studied and compared with two control groups: 100 patients with limb trauma aud 164 healthy subjects. In the group with the head injury the electrocardiographie findings were correlated with the level of consciousness. The possible relationship between head trauma and eleetrocardiographic changes was first suggested by Bramwell.1 lie described a miner, aged 35 years, who, after a blow oni the head that did not cause him to lose colisciousness, developed atrial fibrillation that lasted for 4 weeks. On examination of the cardiovascular and central nervous systems, nothiuog abnormal was found. Lucke2 described a 54-year-old man who fell from a ladder and was found to have blocked atrial extrasystoles after a l)eriod of concussion. Ilis cardiovascular system was clinically nornial. Doret and Forrero3 studied 32 cases of "traumatic enieephalopathy" without clinical evidence of cardiovascular disease. They described various changes but did not find a characteristic eleetrocardiographic traciilwt. They divided their cases into six "'sympatheticotonie'" (tachycardia, raised P waves in leads IT and III, short P-R interval, increased Q-T interval, and shallow T waves), four "parasym)atheticotonic" (bradyeardia, depressed P waves, increased P-R interval, short Q-T interval, and tall T waves), and 22 intermediate types. In addition, one case had ventricular extrasvstoles and one case had paroxysmal supraventrieular tachycardia. Sinus rhythm was present in 23 eases and sinus arrhythmia in nine. Nadas et al.4 described a 5-year-old girl who had a normal pulse 4 weeks prior to a head injury. She was unconscious for 5 min-