Bulbo-spinal pathology in neurocardiac sudden death of adults: a pragmatic approach to a neglected problem.
This paper gives an overview on the neurocardiopathy of reflexogenic sudden death in adults, focusing on the bulbo-spinal cardiovascular-respiratory centers and which is reminiscent of the recent findings in sudden infant death syndrome. The preeminent life-threatening derangements of the oxygen-conserving cardio-inhibitory reflex (dive-reflex and its subsets) were reconsidered in histopathology, together with bulbo-spinal sympathovagal abnormalities and possible underlying arrhythmogenic QT interval prolongation. A simplified methodology for the microscopical examination of the brain stem and upper thoracic spinal cord is suggested. The aim is to facilitate the pathologist's approach to a lamentably neglected, yet fundamental topic in the far-reaching domain of sudden cardiac death with no evidence of cardiovascular respiratory disease.
Institute of Pathology of the University of Milan, Italy.
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D000328:Adult; D017704:Baroreflex; D001927:Brain Diseases / Q000473:pathology; D001933:Brain Stem / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology; D013116:Spinal Cord / Q000473:pathology*