Cardial diseases are common causes of neurological emergencies. On the other hand, acute neurological disorders go along with systemic abnormalities, in particular they show cardial and pulmonary complications. This review is focused on the cardial consequences of cerebral lesions. Independent on the etiology of the brain disorder, the central activation of the adrenergic system plays a key role in the pathophysiology. The adrenergic stimulation modulates cardial function. ECG-changes, elevated cardial enzymes, arrhythmias, and sudden cardial death can be the consequences. In these cases, the adequate treatment of the neurological disorder is essential for the improvement of systemic symptoms. The cardial disorders (apical ballooning cardiomyopathy, neurogenic pulmonary edema) then have a favourable prognosis. For future studies on treatment of neurogenic-cardial disorders, the classification of the differently defined disorders based on their common pathophysiology will be essential.