gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Function of the medulla oblongata in coma after intracranial hemorrhage or head injury

Funktion der Medulla oblongata im Koma nach Hirnblutung oder Schädel-Hirn-Verletzung

Meeting Abstract

  • corresponding author D. Woischneck - Klinik für Neurochirurgie, Universitätsklinikum Magdeburg
  • S. Reissberg - Klinik für Diagnostische Radiologie, Universitätsklinikum Magdeburg
  • C. Grimm - Klinik für Neurochirurgie, Universitätsklinikum Magdeburg
  • M. Skalej - Klinik für Diagnostische Radiologie, Universitätsklinikum Magdeburg
  • R. Firsching - Klinik für Neurochirurgie, Universitätsklinikum Magdeburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-14.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0068.shtml

Published: May 4, 2005

© 2005 Woischneck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

In this study the pathomorphological findings of magnetic resonance imaging (MRI) of the brain were related with the ability of spontaneous respiration after intracranial hemorrhage or head injury.

Methods

In a prospective study MRI was obtained in 270 patients, comatose after brain injury or spontaneous intracranial bleeding. The findings were correlated with the ability of spontaneous breathing. This spontaneous respiration was documented when persisting for more than one hour with normal ranges for pCO2 and pO2 in arterial blood gas analysis.

Results

From 250 patients, 14 (5,6%) were unable to of spontaneous respiration In these cases, MRI always visualized a bilateral lesion of the caudal parts of medulla oblongata: in 4 patients, these medullar lesions were found without accompanying other lesions. These patients awoke from coma prior to death and died due to pneumonia within one year. In 10 cases, the lesions were combined with bilateral damage of the pons, and the patients never awoke from coma prior to death. 94,4% of the patients were able to take breathe on their own, and MRI never revealed a lesion of the caudal medulla oblongata, although extended supratentorial damages were obvious.

Conclusions

The study confirms the existence of an autonomic respiratory center within the caudal parts of medulla oblongata which allows sufficient spontaneous breathing in coma. The study confirms the importance of MRI in comatose patients to predict preservation of spontaneous respiration.