ArticleInternal medicine (Tokyo, Japan)2026
Cognitive Impairment and Central Sleep Apnea Secondary to Tortuous Vertebral Artery Compression of the Medulla, Mimicking Alzheimer's Disease.
Article in Internal medicine (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We report the case of a man in his 60s, who was previously diagnosed with Alzheimer's disease and presented with acute respiratory failure. Investigations revealed severe hypercapnia and central sleep apnea. Imaging revealed a tortuous right vertebral artery compressing the ventral medulla. Cerebrospinal fluid analysis showed a normal amyloid-β 1-42/1-40 ratio, and he exhibited pyramidal and autonomic signs of brainstem involvement. Despite microvascular decompression, the patient remained ventilator dependent. This case illustrates that medullary compression can cause central hypoventilation that mimics a neurodegenerative disorder, with cognitive decline driven by chronic hypoxia rather than by Alzheimer's pathology.
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