Review
Pathophysiological and clinical aspects of breathing after stroke
R S Howarda, A G Ruddb, C D Wolfec, A J Williamsda Department of
Neurology, Guy's and St Thomas' Hospital Trust, London and Batten
Harris Neuromedical Intensive Care Unit, National Hospital for
Neurology and Neurosurgery, Queen Square, London, b Department of Elderly Care, Guy's and St
Thomas' Hospital Trust, London, c Department of Public Health Medicine, Guy's,
King's and St Thomas' School of Medicine, London, d Lane Fox
Unit, St Thomas' Hospital Trust, London
Correspondence to: Dr Robin Howard, Department of Neurology, St Thomas' Hospital, Guy's and St Thomas' Hospital Trust, Lambeth Palace Road, London SE1 7EH, UK
Submitted 2 April 2001;
Accepted 15 May 2001
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Stroke may disrupt breathing either by (A) causing a disturbance of central rhythm generation, (B) interrupting the descending respiratory pathways leading to a reduced respiratory drive, or (C) causing bulbar weakness leading to aspiration.
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Pathophysiology of respiratory control in stroke |
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Neural control of respiration in man depends on a central drive to
the respiratory muscles which is modulated by chemical and mechanical
inputs.1 While many of the factors controlling established
respiratory rhythm in mammals are understood, the neural mechanisms of
rhythm generation remain obscure.2-4 It has proved
difficult, in man, to attribute precise respiratory function to
localised anatomical substrates because lesions are rarely localised
and coexisting pulmonary, cardiovascular, or autonomic influences may
complicate the clinical picture. Furthermore accurate diagnosis of
respiratory insufficiency has led to earlier therapeutic intervention
with controlled ventilation. Also there is probably considerable
redundancy and plasticity of the neural substrate of respiratory
control, thus congenital, longstanding, or slowly progressive and
destructive mass lesions
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This article has been cited by other articles:
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Howard, R. S, Davidson, C.
(2003). Long term ventilation in neurogenic respiratory failure. J. Neurol. Neurosurg. Psychiatry
74: iii24-30
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