Stroke Unit, Department of Neurology, Faculty of Medicine, Ege University, Izmir, Turkey.
Eur Neurol. 2011;66(2):70-4. doi: 10.1159/000327538. Epub 2011 Jul 22.
Previous clinicopathological studies have reported central hypoventilation alongside unilateral infarcts in the caudal brainstem. As already known, the respiratory centers are located in the medullary and pontine centers.
We sought patients with acute respiratory failure with brainstem involvement proved by MRI from 4,500 patients with first ischemic stroke consecutively admitted to our stroke unit over a period of 7 years.
We report six patients with a unilateral dorsolateral medulla oblongata lesion, completely sparing the corticospinal tract, who presented impairments in automatic and voluntary respiratory movements. Topographical analysis showed involvement of the nucleus and tractus solitarius,nucleus ambiguus and retroambiguus,nucleus reticularis medulla oblongata, and nucleus tractus solitarius.
Our findings provide insight into the central organization of respiratory control in the dorsolateral medulla oblongata in humans, and the importance of critical respiratory management in these patients.
之前的临床病理研究报告了尾状脑干单侧梗死伴中枢性通气不足。众所周知，呼吸中枢位于延髓和脑桥中枢。
我们从连续 7 年在我们的卒中病房收治的 4500 名首次缺血性卒中患者中，寻找了 MRI 证实有脑干受累的急性呼吸衰竭患者。
我们报告了 6 例单侧背外侧延髓病变患者，完全不涉及皮质脊髓束，他们表现出自动和自主呼吸运动受损。 局灶性分析显示涉及孤束核和孤束核、疑核和后疑核、网状结构延髓和孤束核。
我们的发现为人类背外侧延髓呼吸控制的中枢组织提供了深入了解，并强调了这些患者进行关键呼吸管理的重要性。
