title: Acute respiratory failure due to unilateral dorsolateral bulbar infarction.
abstract: BACKGROUND
  Previous clinicopathological studies have reported central hypoventilation alongside unilateral infarcts in the caudal brainstem. As already known, the respiratory centers are located in the medullary and pontine centers.
  
  
  METHODS
  We sought patients with acute respiratory failure with brainstem involvement proved by MRI from 4,500 patients with first ischemic stroke consecutively admitted to our stroke unit over a period of 7 years.
  
  
  RESULTS
  We report six patients with a unilateral dorsolateral medulla oblongata lesion, completely sparing the corticospinal tract, who presented impairments in automatic and voluntary respiratory movements. Topographical analysis showed involvement of the nucleus and tractus solitarius,nucleus ambiguus and retroambiguus,nucleus reticularis medulla oblongata, and nucleus tractus solitarius.
  
  
  CONCLUSIONS
  Our findings provide insight into the central organization of respiratory control in the dorsolateral medulla oblongata in humans, and the importance of critical respiratory management in these patients.
authors.affiliation: Stroke Unit, Department of Neurology, Faculty of Medicine, Ege University, Izmir, Turkey. emre.kumral@ege.edu.tr
authors.forename: Emre
authors.initials: E
authors.lastname: Kumral
authors.forename: Cihat
authors.initials: C
authors.lastname: Uzunköprü
authors.forename: Seyma
authors.initials: S
authors.lastname: Çiftçi
authors.forename: Tenzile
authors.initials: T
authors.lastname: Demirci
mesh_terms: D000208:Acute Disease; D000368:Aged; D020520:Brain Infarction / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology*; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000209:etiology*