Ataxic breathing in neurocritical care: malignant cerebral infarction without evident brainstem lesion on serial ct a case report
Introduction: Biot’s breathing, an ataxic pattern, is characterized by irregular ventilation with variable tidal volumes and unpredictable apneic pauses. It is classically associated with medullary lesions; however, it may occur without focal brainstem injury in extensive hemispheric infarctions wit...
Saved in:
| Hovedforfatter: | |
|---|---|
| Andre forfattere: | , , , |
| Format: | article |
| Sprog: | spa |
| Udgivet: |
2026
|
| Fag: | |
| Online adgang: | https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/8640 |
| Tags: |
Tilføj Tag
Ingen Tags, Vær først til at tagge denne postø!
|
Tilføj Tag | Summary: | Introduction: Biot’s breathing, an ataxic pattern, is characterized by irregular ventilation with variable tidal volumes and unpredictable apneic pauses. It is classically associated with medullary lesions; however, it may occur without focal brainstem injury in extensive hemispheric infarctions with dysfunction of the central respiratory network. Objective: To describe the case of a neurocritical patient with a right malignant hemispheric infarction who developed Biot’s breathing documented on mechanical ventilation, without evidence of structural involvement of the medulla or pons on serial neuroimaging. Case presentation: A 90-year-old woman was admitted to the ICU with an initial diagnosis of non-traumatic subdural hemorrhage and pneumonia. Computed tomography showed an extensive right hemispheric infarction with edema and midline shift. During her course, she developed a pattern consistent with Biot’s breathing, demonstrated on ventilator waveforms, despite follow-up neuroimaging showing no involvement of the medulla or pons. She required prolonged invasive mechanical ventilation, with tracheostomy and gastrostomy, and remained in a stationary neurological phase with a reserved prognosis. Discussion: The occurrence of Biot’s breathing without visible bulbar lesions supports a mechanism of functional dysfunction of the respiratory network due to mass effect and diffuse brain injury. This pattern should be interpreted as a multicausal syndrome with reversible and irreversible etiologies, which shapes ventilatory strategy, limits weaning, and requires clear prognostic communication and shared decision-making with the family. It provides objective ventilatory documentation in the ICU. |
|---|