ECG - Intracranial Pressure

Question 1

Describe the three characteristics of an ECG for diagnosis of raised ICP.

Answer 1

• Widespread GIANT T-wave inversion (“Cerebral T-waves”)
• QT prolongation
• Bradycardia

Question 2

Explain “Cushing’s Triad”

Answer 2

Changes to patient presentation 2/2 brainstem herniation:

• Bradycardia
• Irregular respirations
• Increased BP/Widening pulse pressure

Question 3

Cerebral T-waves and QT prolongation are seen in ____ of patients with subarachnoid hemorrhage and ____ of intraparenchymal hemorrhage.

Answer 3

72%, 57% (in a case series)

Question 4

A fast way to measure QT prolongation is to see if ______.

Answer 4

Measure the R-R interval. If the the t-wave ends after the 1/2 way mark on the R-R, it’s prolonged.