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Neurovascular Contact of Cranial Nerve IX and X Root-Entry Zone in Hypertensive Patients.
MedLine Citation:
PMID:  11208774     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
-Neurovascular contact of the left rostral ventrolateral medulla has been implicated in the pathogenesis of "essential" hypertension, and recent intervention studies suggest that surgical decompression of the ventrolateral medulla lowers blood pressure in these patients. We assessed the prevalence of this vascular anomaly in patients with essential hypertension by using an advanced MRI technique. We performed MRI of the brain stem in 125 hypertensive patients and in 105 age-matched, sex-matched, and body mass index-matched normotensive control subjects. Imaging of the root-entry zone of cranial nerves IX and X was performed by combining a high-resolution 3D constructive interference in steady-state sequence with a flow-sensitive time-of-flight technique, and images were independently assessed by 4 readers using predefined criteria. Left-sided neurovascular contact was found in 23% of the hypertensive patients and in 16% of the normotensive individuals (P:=0.12). Blood pressure level, heart rate, and number of antihypertensive medications in treated hypertensive patients were similar among patients with positive, borderline, and negative brain stem findings. Our findings cast doubt on the importance of left-sided neurovascular contact as a frequent cause of essential hypertension or as a major factor determining the severity of hypertension in patients with this anomaly.
Authors:
Henriette Hohenbleicher; Stephan A. Schmitz; Hans-Christian Koennecke; Ralf Offermann; Jens Offermann; Helen Zeytountchian; Karl-Jürgen Wolf; Armin Distler; Arya M. Sharma
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Hypertension     Volume:  37     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-Feb-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  -    
Other Details:
Languages:  ENG     Pagination:  176-181     Citation Subset:  -    
Affiliation:
Department of Internal Medicine (H.H., R.O., J.O., H.Z., A.D., A.M.S.), Division of Endocrinology and Nephrology, the Department of Radiology (S.A.S., K.-J.W.), and the Department of Neurology (H.-C.K.), Universitätsklinikum Benjamin Franklin, Berlin, Germany.
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