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Chapter 28 - Respiratory dysfunction

from Section 1 - Clinical manifestations

Published online by Cambridge University Press:  05 August 2012

Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Jan van Gijn
Affiliation:
University Medical Center, Utrecht
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Summary

The study of respiratory dysfunction following a cerebrovascular event may permit localization of the neuroanatomical lesion. In addition, some respiratory dysfunctions are related to the etiology and the prognosis of stroke. This chapter reviews current knowledge regarding these associations. Unilateral hemispheric ischemic strokes appear to affect respiratory function to a modest degree. In contrast to cerebral hemispheric involvement, brainstem strokes may induce a more typical respiratory pattern, allowing more precise correlation between structure and function. Patients with severe obstructive sleep apnea (OSA) syndrome may develop ischemic stroke more frequently, as OSA syndrome with an apnea-hypopnea index (AHI) >30 was associated with stroke in an elderly population. The adverse effects of central hyperventilation may be related to arterial vasoconstriction induced by hypocapnia, leading to decrease in cerebral blood flow but also inducing impairment in cerebral autoregulation and cerebral arterial compliance.
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Stroke Syndromes, 3ed , pp. 319 - 328
Publisher: Cambridge University Press
Print publication year: 2012

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