Abnormal Breathing Patterns Associated With Acute Brain Damage

Jb, North; Jennett, Sheila

doi:10.1001/archneur.1974.00490410086010

Cited by 133 publications

(42 citation statements)

References 12 publications

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“…As previously described, these consist of Cheyne-Stokes respiration (CSR), Cheyne-Stokes variant pattern (CSV), cluster, apneustic and ataxic respirations and tachypnea or "central neurogenic hyperventilation" (CNH). 1 " 8 The occurrence of these abnormalities may be related to the site and extent of the lesion 2 "* as well as to prognosis. 7 The mechanisms underlying these alterations of respiratory patterns are not well understood.…”

Section: Introductionmentioning

confidence: 99%

Respiratory rate and pattern disturbances in acute brain stem infarction.

Lee¹,

Klassen²,

Heaney³

et al. 1976

Stroke

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SUMMARY Respiratory rates and patterns were studied in 23 patients with acute brain stem infarction using impedance pneumography. Autopsy was obtained in six of eight fatal cases. Pontine lesions were present in all patients, with coexistent infarction of midbrain in four and of medulla in nine. Respiratory rate and pattern abnormalities observed included Cheyne-Stokes respiration, CheyneStokes variant pattern and tachypnea. Abnormalities of respiratory rate and pattern of varying duration were observed at some time in all patients. All patients in whom prominent Cheyne-Stokes respiration or tachypnea were observed had extensive bilateral pontine lesions involving both basal and tegmental portions. However, not all patients with large pontine infarcts had Cheyne-Stokes respiration or tachypnea. Cheyne-Stokes respiration was prominent in four patients (two fatal, two nonfatal). Cheyne-Stokes variant pattern was present frequently in four patients (one fatal, three nonfatal). Sustained tachypnea developed in five patients, four of whom died. In ten patients (one fatal, nine nonfatal), normal respiratory rate and pattern predominated with only rare or occasional appearance of Cheyne-Stokes respiration or Cheyne-Stokes variant pattern, especially during sleep. The types of respiratory rate and pattern abnormalities in acute brain stem infarction were not specifically related to the level of lesions, but rather to the size and bilaterality of the lesions. Respiratory alkalosis was present in varying degrees in most patients with either tachypnea or prominent CSR.

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Section: Introductionmentioning

confidence: 99%

Respiratory rate and pattern disturbances in acute brain stem infarction.

Lee¹,

Klassen²,

Heaney³

et al. 1976

Stroke

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show abstract

“…Pneumonia and pulmonary insufficiency occur in 42% and 28% as complications during hospitalization. In 227 spontaneously breathing patients with neurologic disorders, most with intracranial hypertension, North and Jennett found that 60% had breathing abnormalities, including periodic respirations, tachypnea, and irregular breathing [32]. Periodic breathing was not correlated, however, with any particular anatomic site of the neurologic injury.…”

Section: Respiratory Failurementioning

confidence: 99%

Management of Intracranial Hypertension

&NA;

2011

AACN Advanced Critical Care

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Effective management of intracranial hypertension involves meticulous avoidance of factors that precipitate or aggravate increased intracranial pressure. When intracranial pressure becomes elevated, it is important to rule out new mass lesions that should be surgically evacuated. Medical management of increased intracranial pressure should include sedation, drainage of cerebrospinal fluid, and osmotherapy with either mannitol or hypertonic saline. For intracranial hypertension refractory to initial medical management, barbiturate coma, hypothermia, or decompressive craniectomy should be considered. Steroids are not indicated and may be harmful in the treatment of intracranial hypertension resulting from traumatic brain injury.Intracranial hypertension is a common neurologic complication in critically ill patients; it is the common pathway in the presentation of many neurologic and non-neurologic disorders. The underlying pathophysiology of increased intracranial pressure (ICP) is the subject of intense basic and clinical research, which has led to advances in understanding of the physiology related to ICP. Few specific treatment options for intracranial hypertension have been subjected to randomized trials, however, and most management recommendations are based on clinical experience.

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“…Supratentoryal ve medullar lezyonlarda da nörojenik hiperventilasyonun varlığından söz edilmiştir. Bu tabloya sıklıkla pulmoner konjesyon da eşlik eder (20). SVO'yu izleyen nörojenik hiperventilasyon sıklıkla kötü prognoz anlamına gelir (21).…”

Section: Horlamakunclassified

Sleep related breathing disorders and cerebrovascular diseases

Erdinç¹

2010

Türk Beyin Damar Hast Derg

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ÖZETObstrüktif uyku apne sendromu (OSAS), yüksek prevalanslı ve sıklıkla gözden kaçan, solunumla ilişkili bir uyku bozukluğudur. Uykuda üst hava yollarının gevşeyerek hava yolunu tıkaması sonucu oluşur. Gece boyunca sık uyanmalar, hipoksemi, uykunun bölünmesi ve uyku kalitesinin düşmesi ile izlenir. Şiddetli horlama, tanıklı apneler ve gün içi aşırı uykululuk durumu en önemli semptomlardır. Artmış sempatik aktivite, metabolik ve inflamatuvar markerlar, OSAS ve serebrovasküler hastalıklar arasındaki olası ortak mekanizmayı açıklayabilir. Tedavi seçenekleri için bu mekanizmaların çok iyi bilinmesi gerekir. OSAS'ın erken tanısı ve tedavisi bireyleri serebrovasküler ve diğer komplikasyonlardan koruyabilecektir. SLEEP RELATED BREATHING DISORDERS AND CEREBROVASCULAR DISEASES ABSTRACTObstructive sleep apnea (OSA) is a form of sleep disordered breathing, with a high prevalence rate and is often underdiagnosed. It is characterized by frequent episodes of upper airway collapse during sleep, causing recurrent arousals, intermittent hypoxaemia, sleep fragmentation and poor sleep quality. The common clinical symptoms are heavy snoring, witnessed apnea and daytime hypersomnolence, which would help to identify the affected individuals. Increased sympathetic drive, activation of metabolic and inflammatory markers, and impaired vascular function are some of the proposed mechanisms that could explain the association between OSA and cerebrovascular diseases. Understanding these mechanisms is important for identifying treatment strategies. Increased sympathetic drive, activation of metabolic and inflammatory markers, and impaired vascular function are some of the proposed mechanisms that could explain the association between OSA and cardiovascular diseases. Early recognition and treatment of obstructive sleep apnoea may prevent from adverse health consequences.Yazışma Adresi: Oğuz Osman ERDİNÇ Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, ESKİŞEHİR 1 DERLEME REVIEW Epidemiyoloji OSAS'ın prevalans değerleri kadınlarda %9, erkeklerde %24 şeklinde bildirilmiştir (3). SVO da aynı şekilde sık rastlanılan bir tablodur ve ABD'de üçüncü sıklıkta gelen ölüm nedeni olarak bilinmektedir. Olgu sayısı yılda 700.000'e ulaşmış ve akut nörolojik yakınmalarla başvuran olguların yarısını oluşturmuştur (4). Dünyada ele alındığında, SVO ikinci majör ölüm veya uzun süreli maluliyet nedenidir (5). Obstrüktif apne hipopne indeksine (AHI) göre hafif ve orta şiddetteki OSAS'ın varlığı bile, hastaların SVO için önleyici tedavi almaları gerektiğini göstermektedir (6). HorlamakHorlamak, OSAS'ın en önemli belirtecidir (7). Sık horlama faktörü aynı zamanda, hipertansiyon, kalp hastalıkları, demans ve SVO için oldukça önemlidir (8).Horlamak orta yaşlı erkeklerde ortalama %40-45, aynı yaş grupta kadınlarda %25-30 sıklığındadır. Uykuda meydana gelen SVO olguları horlama ile Solunum ile ilişkili uyku bozuklukları (SUB) içinde en sık rastlanılanı obstrüktif uyku apne sendromudur (OSAS). Klinik semptomlar çok iyi bilinmez veya tanımlanmaz ise...

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Abnormal Breathing Patterns Associated With Acute Brain Damage

Cited by 133 publications

References 12 publications

Respiratory rate and pattern disturbances in acute brain stem infarction.

Respiratory rate and pattern disturbances in acute brain stem infarction.

Management of Intracranial Hypertension

Sleep related breathing disorders and cerebrovascular diseases

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