Junctional rhythm during neurosurgical procedure

Alteration of cardiac electrical activity is usually due to primary cardiac pathology, but can also be secondaryto non-cardiac causes, e.g. electrolyte disturbances, hypothermia, esophageal disorders, poisoning, drugsas well as some intracranial events like ischemic stroke, cerebral hemorrhage, subarachnoid hemorrhage,space occupying lesions etc. We present a case of a young male undergoing craniotomy and excisionof intracranial epidermoid presenting with an intraoperative event consisting of multiple episodes ofjunctional rhythm.