Acquired Central Alveolar Hypoventilation as a Sequelae of Brainstem Tuberculoma

Central alveolar hypoventilation (CAH) is a rare condition resulting from brainstem injury, characterised by a loss of automatic breathing. We present a case of a 16-year-old female initially diagnosed with a brainstem glioma based on magnetic resonance imaging brain. Following craniotomy and tumour debulking, she developed episodic apnoea during both wakefulness and sleep. Histopathological analysis of the brainstem specimen unexpectedly revealed a diagnosis of brainstem tuberculoma. Despite the initiation of anti-tuberculous therapy, the patient showed persistent CAH two weeks post-treatment. Management required tracheostomy and long-term pressure-control synchronised intermittent mandatory ventilation (PC-SIMV), which effectively stabilised her respiratory function.