ECG Findings
• Inverted, wide T waves are most notable in precordial leads (can be seen in any lead).
• QT interval prolongation.
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Cerebral T Waves. This ECG was obtained on a patient with a severe acute hemorrhagic CVA
(click on image to enlarge)
Clinical Points To Remember:
1. These are associated with acute cerebral disease, most notably an ischemic cerebrovascular event or subarachnoid hemorrhage.
2. They may be accompanied by ST segment changes, U waves, and/or any rhythm abnormality.
3. Differential diagnosis includes extensive myocardial ischemia.
4. Strongly suspect an intracranial etiology in a patient with altered mental status and these electrocardiographic findings.
![]()
Deep, symmetrical, inverted T waves (arrowhead) with a prolonged QT interval.
• Inverted, wide T waves are most notable in precordial leads (can be seen in any lead).
• QT interval prolongation.
(click on image to enlarge)
Clinical Points To Remember:
1. These are associated with acute cerebral disease, most notably an ischemic cerebrovascular event or subarachnoid hemorrhage.
2. They may be accompanied by ST segment changes, U waves, and/or any rhythm abnormality.
3. Differential diagnosis includes extensive myocardial ischemia.
4. Strongly suspect an intracranial etiology in a patient with altered mental status and these electrocardiographic findings.
