• World Neurosurg · Dec 2020

    Case Reports

    Neurogenic cough associated with hyperintensity in dorsal medulla: case report and anatomical discussion.

    • Menaka Pasangy Paranathala and Patrick Mitchell.
    • Department of Neurosurgery, Royal Victoria Hospital, Newcastle, UK. Electronic address: MParanathala@doctors.org.uk.
    • World Neurosurg. 2020 Dec 1; 144: 196-198.

    BackgroundThe nucleus tractus solitarius and paratrigeminal nucleus, which are implicated in the processing of airway-derived sensory information, are found in the dorsal medulla. The mechanism and localization of higher-order processing of urge to cough is poorly understood, and much of the existing anatomical localization is limited to animal studies.Case DescriptionA 44-year-old Caucasian lady underwent elective foramen magnum decompression for symptomatic Chiari I malformation; postoperatively she had resolution of Chiari symptoms but developed an intractable neurogenic cough. She has no significant medical history or premorbid respiratory issues. Postoperative magnetic resonance imaging of her head demonstrated signal change in the left dorsal medulla, corresponding with the nucleus tractus solitarius and paratrigeminal nucleus.ConclusionsWe suggest that this lesion explains her isolated new cough and localizes the pathway for "urge to cough" to this region of the medulla.Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.

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