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Is There a Place for Microsurgical Vascular Decompression of the Brainstem for Apparent Essential Blood Hypertension? A Review

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Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 42))

Abstract

There are anatomical and physiological evidences that the ventrolateral (VL) region of the medulla plays an important role in blood pressure regulation and that dysfunction at this level may generate hypertension (HT). Vascular compression by a megadolicho-artery from the vertebrobasilar arterial system at the root entry/exit zone (REZ) of the glossopharyngeal (IXth) and vagal (Xth) cranial nerves (CNs) and the adjacent VL aspect of the medulla has been postulated as a causal factor for HT from neurogenic origin. The first attempts at microvascular decompression (MVD) of the IX–Xth CNs together with the neighbouring VL brainstem was revealed promising. These surgical attempts, as well as the numerous MRI studies, with the goal to detect and identify likely responsible neurovascular conflicts (NVC), are reviewed. Established criteria for indication of MVD as an aetiological treatment of apparent essential HT are still needed.

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Authors and Affiliations

  1. Department of Neurosurgery, Hopital Neurologique Pierre Wertheimer, University Lyon 1, G.H.E, 59 Boulevard Pinel, Lyon, 69003, France

    Marc Sindou MD, DSc

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  1. Marc Sindou MD, DSc
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Correspondence to Marc Sindou MD, DSc .

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  1. Medizinische Fakultät, Univ.Klinikum Bonn Med. Einrichtungen, Bonn, Germany

    Johannes Schramm

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Sindou, M. (2015). Is There a Place for Microsurgical Vascular Decompression of the Brainstem for Apparent Essential Blood Hypertension? A Review. In: Schramm, J. (eds) Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 42. Springer, Cham. https://doi.org/10.1007/978-3-319-09066-5_4

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  • DOI: https://doi.org/10.1007/978-3-319-09066-5_4

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