PURPOSE: Autonomic imbalance as measured by heart rate variability (HRV) has been associated with poor outcome after stroke. Observations on HRV changes in intracerebral hemorrhage (ICH) are scarce. Here, we aimed to investigate HRV in ICH as compared to a control group and to explore associations with stroke severity, hemorrhage volume and outcome after ICH. METHODS: We examined the autonomic modulation using frequency domain analysis of HRV during the acute phase of the ICH and in a healthy age- and hypertension-matched control group. Hematoma volume, intraventricular extension, initial stroke severity and baseline demographic, clinical parameters as well as mortality and functional outcome were included in the analysis. RESULTS: 47 patients with ICH and 47 age- and hypertension matched controls were analyzed. ICH patients showed significantly lower total high frequency band (HF) and low frequency band (LF) powers (p = 0.01, p < 0.001), higher normalized HF power (p = 0.03), and lower LF/HF ratio (p < 0.001) as compared to the controls. Autonomic parameters showed associations with stroke severity (p = 0.004) and intraventricular involvement (p = 0.01) and predicted poor outcome independently (p = 0.02). CONCLUSIONS: Autonomic changes seems to be present in acute ICH and are associated with poor outcome independently. This may have future monitoring and therapeutic implications.

1st Dept of Neurology University Hospital Bratislava Comenius University Bratislava Slovakia

Department of Neurology St Anne's University Hospital Brno Czech Republic

Dept of Neurology St John's Hospital Vienna Medical Faculty Sigmund Freud University Vienna Austria

Dept of Neurology St John's Hospital Vienna Medical Faculty Sigmund Freud University Vienna Austria; Dept of Neurology University of Heidelberg Heidelberg Germany

Div of Neurosurgery Department of Clinical Neurosciences Cambridge University Cambridge UK

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