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Updated: Jun 25, 2026
A Murine Model of Cervical Spinal Cord Injury to Study Post-lesional Respiratory Neuroplasticity
Published on: May 28, 2014
Respiratory function after lesions in medulla oblongata
Dieter Woischneck1, Thomas Kapapa, Hans E Heissler
1Klinik für Neurochirurgie, University Hospital, Ulm, Germany. dieter-heinrich.woischneck@uniklinik-ulm.de
Objectives:
To evaluate the correlation of lesions of the brain as visualized in cranial magnetic resonance imaging (MRI) and the ability of spontaneous respiration.
Methods:
In a prospective concept, cranial MRI after traumatic brain injury or spontaneous intracerebral hemorrhage was performed in 250 subjects at an early stage. All MRI findings were correlated with respiratory conditions on the day of examination. Sedation was performed only to facilitate toleration of the artificial ventilation, as and when necessary. Spontaneous respiration could hence be registered clinically.
Results:
Thirteen subjects (5.2%) had no spontaneous respiration. In these cases, a bilateral lesion of the distal medulla oblongata could be displayed. In four of these cases, no additional injuries of the brainstem were detected. These subjects awoke 2 days after the impact with tetraparesis and apnea. Combined lesions of the medulla oblongata and other brainstem regions were found in nine subjects. All these patients died without awakening. In the absence of a bilateral lesion of the caudal medulla oblongata, spontaneous respiration was always possible. A unilateral lesion of the caudal medulla oblongata was visualized in one patient who had the ability of spontaneous respiration.
Conclusions:
This work confirms the presence of autonomous respiratory centers within the caudal medulla oblongata that allows sufficient adequate respiration in coma. Respiration ceases in the presence of a bilateral lesion of this area.
Insights
Bilateral lesions in the caudal medulla oblongata cause cessation of spontaneous respiration in brain injury patients. Preserving this area allows for adequate respiration, even in a coma.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Traumatic brain injury and intracerebral hemorrhage can impact respiratory function.
- Understanding the neural control of respiration is crucial for patient management.
Purpose of the Study:
- To investigate the relationship between brain lesions seen on cranial magnetic resonance imaging (MRI) and spontaneous respiration.
- To identify specific brain regions critical for maintaining respiratory drive.
Main Methods:
- A prospective study involving 250 subjects with traumatic brain injury or intracerebral hemorrhage.
- Cranial MRI was performed early after injury.
- MRI findings were correlated with clinical assessment of spontaneous respiration.
Main Results:
- Bilateral lesions of the caudal medulla oblongata were associated with the absence of spontaneous respiration in 13 subjects (5.2%).
- In subjects without bilateral caudal medulla oblongata lesions, spontaneous respiration was consistently present.
- Unilateral lesions did not abolish spontaneous respiration.
Conclusions:
- The caudal medulla oblongata contains autonomous respiratory centers essential for maintaining respiration.
- Bilateral damage to this area leads to respiratory failure.
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