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Hypoplasia and neuronal immaturity of the hypoglossal nucleus in sudden infant death

Institute of Pathology, "Lino Rossi" Research Centre for the study and prevention of unexpected perinatal death and SIDS, University of Milan, Milan, Italy

Correspondence to:
Dr Giulia Ottaviani
Institute of Pathology, University of Milan, Via della Commenda 19, 20122 Milan, Italy; giulia.ottaviani{at}unimi.it Objective: To report the case of five month old female baby with a history of episodes of gastro-oesophageal reflux and pneumonia. Her sudden death offered a unique insight into the possible role of delayed neuronal maturation and hypoplasia of the hypoglossal nucleus in representing a likely morphological substrate of sudden death.

Methods: Morphometric analysis was carried out with an Image-Pro Plus Image analyser (Media Cybernetics) on both sides of the brain stem.

Results: Hypoplasia and neuronal immaturity of the hypoglossal nucleus were demonstrated, accompanied by hypoplasia of the arcuate nucleus.

Conclusions: Much attention should be paid to the possible role of the hypoglossal nucleus in determining a lethal outcome in infancy through impairment of deglutition and subsequent recurrent episodes of pneumonia, and as a necropsy finding.

Abbreviations: SIDS, sudden infant death syndrome

Keywords: hypoglossal nucleus hypoplasia; hypoglossal nucleus neuronal immaturity; aspiration pneumonia; passive smoking; borderline SIDS