Central Sleep Apnea without Cheyne-Stokes Breathing Following an Acute Cerebral Infarction
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Central sleep apnea (CSA) is attributed to medical or neurological conditions including stroke. The association of lesion location and CSA in patients with ischemic stroke has not been well elucidated. A 69-year-old man with a history of hypertension and diabetes mellitus was admitted due to stroke. The brain magnetic resonance imaging showed an acute ischemic stroke in the right ventral thalamus and adjacent hypothalamus. During hospitalization, polysomnography (PSG) was performed because repetitive cessation of respiration during sleep was observed by chance. PSG showed severe CSA; the apnea-hypopnea index (AHI) was 73.5 with a minimum oxygen saturation of 89% and central apnea index (CAI) was 63.0. Two years later, follow-up PSG showed that AHI was 7.2 with a minimum oxygen saturation of 91% and CAI was 1.0. We report the patient with CSA after ischemic stroke with right thalamus and adjacent hypothalamus, which resolved spontaneously with time.
Abstract
Central sleep apnea (CSA) is attributed to medical or neurological conditions including stroke. The association of lesion location and CSA in patients with ischemic stroke has not been well elucidated. A 69-year-old man with a history of hypertension and diabetes mellitus was admitted due to stroke. The brain magnetic resonance imaging showed an acute ischemic stroke in the right ventral thalamus and adjacent hypothalamus. During hospitalization, polysomnography (PSG) was performed because repetitive cessation of respiration during sleep was observed by chance. PSG showed severe CSA; the apnea-hypopnea index (AHI) was 73.5 with a minimum oxygen saturation of 89% and central apnea index (CAI) was 63.0. Two years later, follow-up PSG showed that AHI was 7.2 with a minimum oxygen saturation of 91% and CAI was 1.0. We report the patient with CSA after ischemic stroke with right thalamus and adjacent hypothalamus, which resolved spontaneously with time.
참고문헌 (11)
- Johnson KG, "Frequency of sleep apnea in stroke and TIA patients : a meta-analysis", J Clin Sleep Med, 6, pp.131~137 (2010)
- Stevens D, "Post-stroke sleep-disordered breathing-pathophysiology and therapy options", Front Surg, 5, pp.9~ (2018)
- Lee MC, "Respiratory rate and pattern disturbances in acute brain stem infarction", Stroke, 7, pp.382~385 (1976)
- Nachtmann A, "Cheyne-Stokes respiration in ischemic stroke", Neurology, 45, pp.820~821 (1995)
- American Academy of Sleep Medicine, "International classification of sleep disorders" (2014), American Academy of Sleep Medicine
- Fisse AL, "The association of lesion location and sleep related breathing disorder in patients with acute ischemic stroke", PLoS One, 12, pp.e0171243~ (2017)
- Hermann DM, "Central periodic breathing during sleep in acute ischemic stroke", Stroke, 38, pp.1082~1084 (2007)
- Aleksandrov VG, "Identification of a respiratory related area in the rat insular cortex", Can J Physiol Pharmacol, 78, pp.582~586 (2000)
- Thornton JM, "Identification of higher brain centres that may encode the cardiorespiratory response to exercise in humans", J Physiol, 533(Pt 3), pp.823~836 (2001)
- Eckert DJ, "Central sleep apnea : pathophysiology and treatment", Chest, 131, pp.595~607 (2007)
- Fukushi I, "The role of the hypothalamus in modulation of respiration", Respir Physiol Neurobiol, 265, pp.172~179 (2019)