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Journal of the Korean Geriatrics Society 2006;10(2):146-149.
Published online June 30, 2006.
Catastrophic Respiratory Failure Associated with Unilateral PICA Infarction Involving Lateral Medullar Region
In Uk Song, See Back Lee, Joong Seok Kim, Jae Young An, Yeong In Kim, Kwang Soo Lee
Department of Neurology, College of Medicine, The Catholic University of Korea. ks1007@cmc.cuk.ac.kr
외측 연수를 포함한 일측성 후하소뇌동맥 경색으로 발생한 치명적인 호흡부전
Medullar respiratory centers are composed of ventral and dorsal groups. A direct infarction to their structure could lead to a complete loss of respiratory drive, despite unilateral brainstem lesion is rarely associated with central respiratory dysfunction. A 70-year-old man was admitted with sudden dizziness and disequilibrium without motor weakness. Brain MRI (diffuse weight image) shows high signals intensities on left PICA territory of cerebellum and medulla oblongata including reticular formation, nucleus of tractus solitarius, nucleus ambiguus, and nucleus retroambiguus but sparing corticospinal and corticobulbar pathway. On 3rd hospital day, he had a complete loss of respiratory drive involving both autonomic and voluntary components. He didn't get the respiratory drive during CO2 retention while his consciousness and motor power were preserved.
Key Words: Respiratory center, Medulla oblongata, Central respiratory dysfunction
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