J Korean Geriatr Soc.  2006 Jun;10(2):146-149.

Catastrophic Respiratory Failure Associated with Unilateral PICA Infarction Involving Lateral Medullar Region

• Song IU
• Lee SB
• Kim JS
• An JY
• Kim YI
• Lee KS

Abstract

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.

Keyword

Respiratory center; Medulla oblongata; Central respiratory dysfunction

MeSH Terms

Aged
Brain
Brain Stem
Cerebellum
Consciousness
Dizziness
Humans
Infarction*
Magnetic Resonance Imaging
Medulla Oblongata
Pica*
Respiratory Center
Respiratory Insufficiency*
Reticular Formation