The brainstem and vulnerability to sudden infant death syndrome.

Abstract

Sudden infant death syndrome (SIDS), as defined more than 30 years ago, is the sudden unexpected death of a previously healthy infant aged less than 1 year for whom a complete investigation, including case history and death scene and postmortem examinations, does not reveal cause of death. Previously, it was assumed that a single cause might explain these deaths. Subsequently, it has been found that several pathologic entities that are often virtually indistinguishable from SIDS can cause sudden death in infants. A commonly held concept is that for a SIDS death to occur, at least three conditions must be present, the so-called “triple-risk model.”1 First, the infant must have a congenital or acquired underlying vulnerability. Second, there must be a maturational process creating a peak age of vulnerability, occurring at age 2 to 6 months. Finally, a precipitating stress must be present that brings about the sudden death, generally assumed to be cardiovascular or respiratory in origin. Given these concepts, there has been great interest in discovering the source of underlying vulnerability, either physiologic …