Respiratory rate and pattern disturbances in acute brain stem infarction

Area of Science:

• Neurology
• Respiratory Physiology

Background:

• Acute brain stem infarction can significantly impact vital functions.
• Understanding respiratory abnormalities is crucial for patient management.

Purpose of the Study:

• To investigate respiratory rate and pattern abnormalities in patients with acute brain stem infarction.
• To correlate these abnormalities with lesion characteristics.

Main Methods:

• Studied 23 patients with acute brain stem infarction using impedance pneumography.
• Correlated respiratory patterns with pontine, midbrain, and medullary lesion extent and bilaterality.
• Autopsy data was obtained in six fatal cases.

Main Results:

• All patients exhibited some respiratory abnormalities, including Cheyne-Stokes respiration (CSR), CSR variant pattern, and tachypnea.
• Prominent CSR or tachypnea were associated with extensive bilateral pontine lesions.
• Respiratory abnormalities were related to lesion size and bilaterality, not specific lesion level.
• Respiratory alkalosis was common in patients with tachypnea or prominent CSR.

Conclusions:

• Respiratory pattern abnormalities are common in acute brain stem infarction.
• Lesion characteristics, specifically size and bilaterality, are key determinants of respiratory changes.
• These findings aid in understanding the pathophysiology and clinical presentation of brain stem stroke.