Unexpected sudden death after lateral medullary infarction

Jaster, J. Howard

doi:10.1136/jnnp.70.1.137

Cited by 19 publications

(19 citation statements)

References 3 publications

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“…In these cases, the mechanism of death is uncertain, but it may be attributed to demyelinating lesions of neural structures that control cardiovascular and/or respiratory functions (ie, hypothalamus and brainstem). Different types of lesions in these locations (especially in the hypothalamus and medulla) are known to lead to sudden cardiopulmonary arrest 23 either by local compression, 23,24 hemorrhage, 24 infiltration by tumors, 23 anoxia, 25 or inflammation. 26 Neuronal circuits in hypothalamus, medulla, and spinal cord are important for regulation of cardiac and respiratory rhythms.…”

Section: Discussionmentioning

confidence: 99%

Causes of Unexpected Death in Patients With Multiple Sclerosis

Riudavets

Colegial

Rubio

et al. 2005

American Journal of Forensic Medicine &Amp; Pathology

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To determine the cause of death (as a result of neurologic or nonneurologic complications or accidents) in patients with multiple sclerosis (MS), we reviewed the autopsies of 50 subjects with MS from the Office of the Chief Medical Examiner of Maryland (OCME) between 1982 and 2004. The series included 32 females and 18 males (mean age, 45.8 years; range, 25-69 years) and the causes of death were classified into 3 categories: (A) neurologic complication directly related to MS; (B) nonneurologic complications or other medical causes; and (C) accidents, etc. Of the 50 cases, in 43 there was a history of MS, but in 7 subjects there was not, and the diagnosis was established by neuropathologic examination. In Group A, 21 (42%) cases, deaths were directly related to a neurologic complication; in Group B, 14 (28%) cases were related to the following nonneurologic and medical causes: ASCVD 9 (18%), metabolic disorder 1 (2%), pulmonary embolism 3 (6%), and bronchopneumonia 1 (2%); and in Group C, 15 (30%) cases, deaths were due to trauma, 9 (18%); intoxication, 5 (10%); and thermal injury, 1 (2%). Thus, among the 50 subjects, in 26, deaths occurred naturally; and in 24, from accidents, homicides, suicides, or undetermined causes. Pathologically, the majority of cases showed either chronic inactive (66.7%) or chronic active (15.6%) demyelinating lesions, mainly in the cerebral hemispheres. In some cases, it appears that demyelinating lesions, involving brain regions that regulate cardiorespiratory activity, could be considered as the immediate cause of death, but a large proportion appears to be due to other causes such as accidents and trauma. Thus, it seems likely that taking specific precautions could prevent some deaths in MS.

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Section: Discussionmentioning

confidence: 99%

Causes of Unexpected Death in Patients With Multiple Sclerosis

Riudavets

Colegial

Rubio

et al. 2005

American Journal of Forensic Medicine &Amp; Pathology

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“…7,8,10,11 Bogous- (5); inferior olivary nucleus (6); spinothalamic tract (7); nucleus ambiguus (8); solitary nucleus (9); descending sympathetic tract (10); vagus nerve (X) (11); descending trigeminal tract (12); ascending trigeminal thalamic tract (13); inferior cerebellar peduncle (14); vestibular nucleus (15); dorsal nucleus of vagus (16); medullary reticular formation (17). slavsky et al 8 reported that the automatic respiration was impaired by damage to the pontomedullary reticular formation and nucleus ambiguus, and that with a lesion of the solitary nucleus as well the voluntary respiration may also be affected.…”

Section: Discussionmentioning

confidence: 99%

“…8 Moreover, it has recently been pointed out that ischemia of the solitary nucleus in LMS may induce cardiopulmonary arrest in the acute stage. 15,16 If LMS is suspected, one should take into account not only peripheral respiratory impairment such as aspiration, 17 but also the possibility of the central, fatal impairment of apnea or ataxic respiration. Careful management with cardiopulmonary monitoring is particularly important in the acute stage of LMS.…”

Section: Discussionmentioning

confidence: 99%

Rapidly progressive fatal respiratory failure (Ondine’s curse) in the lateral medullary syndrome

Terao

Miura

Osano

et al. 2004

Journal of Stroke and Cerebrovascular Diseases

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“…[3][4][5] Various mechanisms have been postulated for the sudden cardiorespiratory arrest in LMS including cardiac arrhythmia [3] and ischemic penumbra affecting the cardiac and respiratory centers of the medulla. [4] A recent neuropathological study of Þ ve patients disclosed ischemic lesions in the solitary tract nuclei of the medulla after subacute hypoperfusion of the brain during acute heart failure.…”

mentioning

confidence: 99%