Kobayashi Hiroki, Yamada Ryuta, Nomura Yuichi, Oka Naoki, Kokuzawa Jouji, Kaku Yasuhiko
Department of Neurosurgery, Asahi University Hospital, Gifu, Japan.
J Neurosurg Case Lessons. 2025 Jun 23;9(25). doi: 10.3171/CASE25172.
Central hypoventilation syndrome due to unilateral cerebellomedullary infarction is rare and difficult to manage using conventional treatment. Diaphragm pacing can support ventilation in patients with hypoventilation syndrome, mainly because of the high risk of cervical injury. There have been few reports of diaphragm pacing for central hypoventilation syndrome due to unilateral cerebellomedullary infarction.
A 77-year-old man presented with dizziness, truncal ataxia, and dysarthria. MRI showed cerebral infarction in the right lateral medulla oblongata and right cerebellar hemisphere. The patient presented with respiratory failure immediately after admission. The patient required mechanical ventilation and tracheostomy support. Spontaneous breathing was insufficient, particularly during sleep. After a 2-month interval, the ventilator-dependent patient underwent diaphragm pacing. He was weaned from the ventilator 13 days after diaphragm pacing.
The authors reported successful treatment with diaphragm pacing for central hypoventilation syndrome due to unilateral cerebellomedullary infarction. Diaphragm pacing is a good treatment option for patients with central hypoventilation syndrome. https://thejns.org/doi/10.3171/CASE25172.
单侧小脑延髓梗死所致的中枢性低通气综合征较为罕见，采用传统治疗方法难以处理。膈肌起搏可支持低通气综合征患者的通气，主要是因为存在颈部损伤的高风险。关于单侧小脑延髓梗死所致中枢性低通气综合征的膈肌起搏报道较少。
一名77岁男性患者出现头晕、躯干共济失调和构音障碍。MRI显示右侧延髓外侧和右侧小脑半球脑梗死。患者入院后立即出现呼吸衰竭。患者需要机械通气和气管切开支持。自主呼吸不足，尤其是在睡眠期间。间隔2个月后，依赖呼吸机的患者接受了膈肌起搏。膈肌起搏13天后，他成功脱机。
作者报道了膈肌起搏成功治疗单侧小脑延髓梗死所致中枢性低通气综合征。膈肌起搏是中枢性低通气综合征患者的一种良好治疗选择。https://thejns.org/doi/10.3171/CASE25172 。
