Abstract
Many factors, such as prematurity, low weight and minor infection, may predispose to Sudden Infant Death Syndrome (SIDS) but not cause it. It is suggested that the ultimate act of dying is due to the occlusion of one or both vertebral arteries triggered by the position of the head and cervical spine. When the head is turned to one side, the ipsilateral vertebral artery may be occluded at mid-cervical level along its length, or the contra lateral artery at atlanto-axial level or on both sides with the head in the initial position. Extension of cervical spine, with or without rotation, may produce obstruction of one or both vertebral arteries. If the degree, the levels and duration of occlusion are exceeded, particularly if there is a degree of failure of the collateral circulation (including one from carotid arteries via posterior communicating arteries), this can lead to prolonged apnoea, a 'near-miss' or cot death. The factors which may predispose to SIDS among others are hypoplasia or 'unexercised' vertebral arteries (in utero) and/or hypermobility of the immature cervical spine with lax joint capsules and ligaments. These factors allow the undue stretch or kinking of the vertebral arteries resulting in occlusion when the hea...Continue Reading