title: Neurologic causes of cardiac arrest and outcomes.
abstract: BACKGROUND
  Sudden cardiac arrest as a complication of neurologic disorders is rare, occasionally acute neurologic events present with cardiac arrest as initial manifestation.
  
  
  OBJECTIVE
  Our aim was to describe neurologic disorders as a cause of cardiac arrest in order to enable better recognition.
  
  
  METHODS
  We retrospectively analyzed prospectively collected resuscitation data of all patients treated between 1991 and 2011 at the emergency department after cardiac arrest caused by a neurologic event, including diagnosis, therapy, and outcomes.
  
  
  RESULTS
  Over 20 years, 154 patients suffered cardiac arrest as a result of a neurologic event. Out-of-hospital cardiac arrest occurred in 126 (82%) patients, 78 (51%) were male, median age was 51 years (interquartile range 17 to 89 years). As initial electrocardiogram rhythm, pulseless electrical activity was found in 77 (50%) cases, asystole in 61 (40%), and ventricular fibrillation in 16 (10%) cases. The most common cause was subarachnoid hemorrhage in 74 (48%) patients, 33 (21%) patients had intracerebral hemorrhage, 23 (15%) had epileptic seizure, 11 (7%) had ischemic stroke, and 13 (8%) had other neurologic diseases. Return of spontaneous circulation was achieved in 139 (90%) patients. Of these, 22 (14%) were alive at follow-up after 6 months, 14 (9%) with favorable neurologic outcome, 8 of these with epileptic seizure, and most of them with history of epilepsy.
  
  
  CONCLUSIONS
  Subarachnoidal hemorrhage is the leading neurologic cause of cardiac arrest. Most of the patients with cardiac arrest caused by neurologic disorder have a very poor prognosis.
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Pia
authors.initials: P
authors.lastname: Hubner
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Giora
authors.initials: G
authors.lastname: Meron
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Istepan
authors.initials: I
authors.lastname: Kürkciyan
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Weiser
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Wallmüller
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Mathias
authors.initials: M
authors.lastname: Stöckl
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schober
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Raphael
authors.initials: R
authors.lastname: van Tulder
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000628:therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: cardiac arrest; cause of death; intracerebral hemorrhage; stroke; subarachnoid hemorrhage