Cerebral T Waves On EKG From Intracranial Bleeding Stroke (Picture).

Did you know a stroke could cause EKG changes?  Below is an example of an EKG showing inverted cerebral T waves as a consequence of an intracrantial hemorrhage (bleeding stroke). Cerebral T waves have been  known to be symmetric and deeply inverted in patients with hemorrhagic strokes.  This finding is not my normal presentation I see as a hospitalist, but when present, these deeply and symmetrically inverted T waves should alert the clinician to the possibility of a bleeding stroke.  This patient had a  cardiac echo confirming  normal wall motion.

I don't know nor do I understand the physiology associated with inverted T waves on ECG from a hemorrhagic stroke.  A residency attending physician told me years ago the ABIM had a question on this clinical exact scenario.    They missed the question, but I don't think I ever will.  I don't think a single resident from my program will ever miss this type of  question ever again.  Go here to review my collection of other interesting and educational EKGs.