title: Central alveolar hypoventilation (Ondine's curse) caused by megadolichobasilar artery.
abstract: Central alveolar hypoventilation (CAH) syndrome is a clinical condition that is characterized by the loss of automatic breathing, particularly during sleep. Most forms in adults are caused by brainstem ischemia, mass, infection, demyelinating disease, or anoxic-ischemic damage. We present a case of a fatal symptomatic acquired CAH syndrome caused by megadolichobasilar artery. A 62-year-old man with pre-existing vascular dementia suffered an acute posterior stroke. During stroke care, long episodes of hypopnea and apnea were observed which responded well to verbal reminders. During an unobserved episode, the patient was found unresponsive, with chemical signs of prolonged hypoventilation not explainable by cardiopulmonary disease. A diaphragmatic pacemaker, assisted ventilation, and repeated resuscitation were refused by the patient, who died some days later. CAH is a rare complication that can occur in patients with megadolichobasilar artery.
authors: Department of Neurology, Municipal Hospital Landshut, Landshut, Germany. Electronic address: josef.heckmann@klinikum-landshut.de.
authors: Josef G
authors: JG
authors: Heckmann
authors: Department of Radiology, Municipal Hospital Landshut, Landshut, Germany.
authors: Stefan
authors: S
authors: Ernst
mesh_terms: D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography / Q000379:methods; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D007040:Hypoventilation / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012125:Respiratory Center / Q000503:physiopathology; D012307:Risk Factors; D012890:Sleep; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016312:Treatment Refusal
keywords: Brainstem affection; Ondine's curse; central alveolar hypoventilation; megadolichobasilar artery