Bulbo-spinal pathology in neurocardiac sudden death of adults: a pragmatic approach to a neglected problem

Int J Legal Med. 1999;112(2):83-90. doi: 10.1007/s004140050207.

Abstract

This paper gives an overview on the neurocardiopathy of reflexogenic sudden death in adults, focusing on the bulbo-spinal cardiovascular-respiratory centers and which is reminiscent of the recent findings in sudden infant death syndrome. The preeminent life-threatening derangements of the oxygen-conserving cardio-inhibitory reflex (dive-reflex and its subsets) were reconsidered in histopathology, together with bulbo-spinal sympathovagal abnormalities and possible underlying arrhythmogenic QT interval prolongation. A simplified methodology for the microscopical examination of the brain stem and upper thoracic spinal cord is suggested. The aim is to facilitate the pathologist's approach to a lamentably neglected, yet fundamental topic in the far-reaching domain of sudden cardiac death with no evidence of cardiovascular respiratory disease.

Publication types

  • Review

MeSH terms

  • Adult
  • Baroreflex
  • Brain Diseases / pathology
  • Brain Stem / pathology*
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / pathology*
  • Humans
  • Long QT Syndrome / etiology
  • Spinal Cord / pathology*