Cardiac arrhythmia associated with reversible damage to insula in a patients with subarachnoid hemorrhage.

Background: The insular cortex has been shown experimentally to contain an arrhythmogenic center that may play an important role in the genesis of cardiac arrhythmias and electrocardiographic changes in patients with intracranial (eg, cerebrovascular) lesions. The description of our case is intended to substantiate this claim with a clinical observation.

Case Description: A 37-year-old woman with subarachnoid hemorrhage suffered a severe reversible cardiac arrhythmia after neurosurgical clipping of an arterial aneurysm and removal of an intracerebral hematoma from the region of the left insula.

Conclusions: The observed association of a neurosurgical intervention in the region of the left insular cortex with a cardiac arrhythmia supports but does not prove the suggested role of the insulin in the causation of heart rhythm disturbances after stroke.