Authors: Mauricio Michalak Sendeski Fernanda Marciano ConsolimColombo Eduardo Moacyr Krieger Cláudia da Costa Leite
Publish Date: 2005/12/06
Volume: 48, Issue: 1, Pages: 21-25
Abstract
Hypertension HTN has been controversially related to neurovascular compression NVC at the rostral ventrolateral RVL medulla in anatomical surgical and radiological reports Our objective was to investigate the association between primary HTN and signs of NVC at the medulla oblongata on magnetic resonance imaging MRI and to explore a new classification based on image criteria Subjects with n=64 and without n=29 HTN were studied Threemillimeter slices with 1mm intervals in between were performed on T2weighted images in axial and coronal views Attention was focused on the relationship between the upper medulla and the surrounding arteries The findings were divided into three categories 1 nonNVC absence of signs of NVC 2 NVC type I an artery in contact with the RVL medulla but not compressing it and 3 NVC type II evident compression of the RVL medulla by an artery Signs of NVC were observed in 657 42/64 of the HTN group type I 391 25/42 patients type II 266 17/42 patients Among the normotensive subjects 276 8/29 had signs of NVC only one 33 of these had NVC type II evident compression and the rest were NVC type I We conclude that the presence of NVC at the RVL medulla on MRI is related to HTN More importantly the finding of frank compression NVC type II is present almost exclusively in hypertensive subjects only one individual 33 of our normotensive population had NVC type II
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