Central Hypoventilation: A Rare Complication of Wallenberg Syndrome

Sivakumar, Keithan; Garcha, Manveer; Mehta, Dev; Leary, Megan; Yacoub, Hussam A.

doi:10.1155/2018/4894820

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…However, traumatic, ischemic, and inflammatory insults to the brainstem can also cause acquired CAH ( 1 – 8 ). Although the respiratory centers receive bilateral reciprocal inputs, patients with unilateral caudal brainstem lesion have been reported to develop CAH ( 1 , 2 , 4 , 5 , 8 ). Damage to C2 nerve fibers were also implicated in patients developing CAH after high cervical cord injury ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Central alveolar hypoventilation in a survivor of cardiopulmonary arrest

Wang

Darby

2023

Front. Neurol.

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IntroductionOndine’s curse is a rare respiratory disorder that is characterized by central alveolar hypoventilation (CAH) during sleep. It is most commonly congenital. However, it can also be acquired very rarely. Herein, we report a young survivor who developed CAH following cardiopulmonary arrest.Case presentationA 35-year-old man was admitted to the Intensive Care Unit following unwitnessed cardiopulmonary arrest. Following resuscitative interventions, he remained comatose. Early diagnostic testing showed elevated neuronal specific enolase (28.7 ng/ml), absent cortical responses on evoked potential testing and MRI evidence of restricted diffusion in the cerebellum, hippocampi, juxtacortical white matter, superior cerebellar peduncles, dorsal pons, dorsolateral medulla, and upper cervical spinal cord. Ten days following admission, the patient remained comatose and underwent tracheostomy. He subsequently began to emerge from coma but had persistent unexplained hypotension and bradypnea necessitating ongoing vasopressor and respiratory support. Repeat MRI on hospital day 40 revealed residual FLAIR hyperintensities in the medulla within the nucleus tractus solitarius (NTS). After being discharged to long-term acute care facility, he was successfully liberated from mechanical ventilation 70 days post arrest.ConclusionWe report the first survivor of cardiopulmonary arrest who was complicated by CAH and hypotension with MRI verified ischemic injury to the bilateral NTS regions. Despite this injury, ventilator and vasopressor dependency resolved over a period of 10 weeks. Our case highlighted the essential functions of NTS in regulating the respiratory and cardiovascular systems.

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Section: Discussionmentioning

confidence: 99%

Case report: Central alveolar hypoventilation in a survivor of cardiopulmonary arrest

Wang

Darby

2023

Front. Neurol.

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“…These include a AV malformation with an extra-cranial PICA [4], lateral medullary stroke with epicrania fugax [5], aneurysmal lateral medullary stroke [6], lateral medullary stroke with vestibulopathy [7], sarcoidosis presenting as lateral medullary stroke [8] and central hypoventilation with a lateral medullary stroke [9].…”

Section: Discussionmentioning

confidence: 99%

A case of lateral medullary syndrome with unilateral selective thermoanaesthesia

2019

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A 42-year-old female was admitted to tertiary care teaching hospital with history of headache, vertigo, difficulty in swallowing both liquids and solids, vomiting, gait ataxia, drooping of left eyelid, inability to feel hot and cold on right side of body and diplopia of forty-fivedays' duration. Clinical examination and neuroimaging were suggestive a posterior circulation stroke, with lateral medullary syndrome.The patient had selective thermoanaesthesia on the right side, including the face, which is an atypical finding, given the clinical setting.

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“…22 Estas manifestaciones incluyen: vértigo, nistagmus, diplopía, síndrome de Horner, rubicundez facial ipsilateral, disfonía, disfagia, disartria, pérdida ipsilateral del reflejo nauseoso, ataxia ipsilateral, disgeusia ipsilateral, dolor y parestesia facial ipsilateral, pérdida o diminución ipsilateral del reflejo corneal, hipoalgesia y termoanestesia de tronco y extremidades contralaterales, hipoalgesia y termoanestesia facial ipsilateral. 2,12,13,[23][24][25] Además de los hallazgos clásicos que pueden o no presentarse en su totalidad, el síndrome de Wallenberg se ha descrito como causa de epicrania fugax, 26 distonía cervicobraquial, 27 hipoventilación central, 28 queratopatía neurotrófica y punteada, 4,23 manía 29 y disfunción autonómica cardiovascular (con hipotensión ortostática). 30 Correlación anatomo-clínica de las manifestaciones neurológicas…”

Section: Anatomía De La Picaunclassified

Síndrome de Wallenberg: correlación neuroanatómica

Ichazo Castellanos,

Abdo Toro,

Garfias Rodríguez

et al. 2024

Acta Médica Grupo Ángeles

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El síndrome de Wallenberg es la presentación clínica más frecuente del evento vascular cerebral en la circulación posterior. Su manifestación clínica incluye una gama diversa de signos y síntomas, la mayor parte de los cuales se explican fácilmente por la correlación anatómica con las estructuras afectadas. Su estudio es un reflejo claro de la importancia de la neuroanatomía en la aplicación clínica. Descrito por primera vez en 1895 por el neurólogo polaco Adolf Wallenberg, el síndrome de Wallenberg es causado por el infarto de la porción lateral y posterior al núcleo olivar inferior del bulbo raquídeo justo en el territorio irrigado por la arteria cerebelosa posteroinferior (PICA). Las causas más comunes y descritas del síndrome de Wallenberg son, en orden de frecuencia, la oclusión aterotrombótica de la arteria vertebral, de la PICA o de las arterias medulares, cardioembolismo y disección vertebral. Sin embargo, existen otras causas menos comunes del síndrome de Wallenberg como lo son el uso de drogas emergentes conocidas como legal highs o "subidones legales", consumo de cocaína, sarcoidosis, granulomatosis con poliangitis (granulomatosis de Wegener), arteritis de células gigantes, picadura por escorpión e incluso por aneurismas de la PICA sin ruptura. En este artículo se revisa las características clínicas específicas del síndrome de Wallenberg y los detalles de las bases neuroanatómicas de sus principales manifestaciones clínicas.Palabras clave: síndrome de Wallenberg, bulbo raquídeo, arteria cerebelosa posteroinferior (PICA), evento vascular cerebral, neuroanatomía.

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Central Hypoventilation: A Rare Complication of Wallenberg Syndrome

Cited by 7 publications

References 22 publications

Case report: Central alveolar hypoventilation in a survivor of cardiopulmonary arrest

Case report: Central alveolar hypoventilation in a survivor of cardiopulmonary arrest

A case of lateral medullary syndrome with unilateral selective thermoanaesthesia

Síndrome de Wallenberg: correlación neuroanatómica

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