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Trends in Reconstructive Neurosurgery pp 221–229Cite as

Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View

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Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 124))

Abstract

Central autonomic control nuclei and pathways are mainly integrated within the brainstem, especially in the medulla oblongata. Lesions within these structures can lead to central dysautonomia.

Central autonomic control structures can be damaged by tumors, during surgery, or by other neurosurgical pathologies. These may elicit clinical or subclinical autonomic complications that can constitute a serious clinical problem.

The authors present a broad review of the central autonomic nervous system, its possible dysfunctions, and the relation between neurosurgery and this “not-well-known system”. Preliminary results of an autonomic study of brainstem lesions that is currently being carried out by the authors are also shown.

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References

  1. Altavilla R, Landi D, Altamura C, Bussone G, Maggio P, Corbetto M et al (2012) Dorsolateral medullary ischemic infarction causing autonomic dysfunction and headache: a case report. J Headache Pain 13(4):327–330. doi:10.1007/s10194-012-0427-8

    Article  PubMed  PubMed Central  Google Scholar 

  2. Baker GS (1965) Physiologic abnormalities encountered after removal of brain tumors from the floor of the fourth ventricle. J Neurosurg 23(3):338–343

    Article  CAS  PubMed  Google Scholar 

  3. Barbizet J, Degos JD, Poirier J, Marsault C, Meyrignac C (1981) Dysautonomia and behavioural disorders from periventricular metastasis. Rev Neurol (Paris) 137(5):319–331

    CAS  Google Scholar 

  4. Barley J, Ellis C (2013) Microvascular decompression: a surgical option for refractory hypertension of neurogenic etiology. Expert Rev Cardiovasc Ther 11(5):629–634. doi:10.1586/erc.13.30

    Article  CAS  PubMed  Google Scholar 

  5. Benarroch EE (1993) The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc 68(10):988–1001

    Article  CAS  PubMed  Google Scholar 

  6. Benarroch EE (2014) The clinical approach to autonomic failure in neurological disorders. Nat Rev Neurol 10(7):396–407

    Article  PubMed  Google Scholar 

  7. Brozman B, Romano JG, Tusa RJ, Forteza AM (2002) Postural vertigo and impaired vasoreflexes caused by a posterior inferior cerebellar artery infarct. Neurology 59(9):1469–1470

    Article  PubMed  Google Scholar 

  8. Cameron SJ, Doig A (1970) Cerebellar tumours presenting with clinical features of phaeochromocytoma. Lancet 1(7645):492–494

    Article  CAS  PubMed  Google Scholar 

  9. Cersosimo MG, Benarroch EE (2013) Central control of autonomic function and involvement in neurodegenerative disorders. Handb Clin Neurol 117:45–57. doi:10.1016/B978-0-444-53491-0.00005-5

    Article  PubMed  Google Scholar 

  10. Cravo SL, Morrison SF, Reis DJ (1991) Differentiation of two cardiovascular regions within caudal ventrolateral medulla. Am J Physiol 261:R985–R994

    CAS  PubMed  Google Scholar 

  11. Dawid-Milner MS, Silva-Carvalho L, Goldsmith GE, Spyer KM (1995) Hypothalamic modulation of laryngeal reflexes in the anaesthetized cat: role of the nucleus tractus solitarii. J Physiol 487(Pt 3):739–749

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. DeArmond SJ, Fusco MM, Dewey MM (1989) Structure of the human brain. A photographic atlas, 3rd edn. Oxford university Press, Inc, New York

    Google Scholar 

  13. Díaz-Casares A, López-González MV, Peinado-Aragonés CA, González-Barón S, Dawid-Milner MS (2012) Parabrachial complex glutamate receptors modulate the cardiorespiratory response evoked from hypothalamic defense area. Auton Neurosci 169(2):124–134. doi:10.1016/j.autneu.2012.06.001, Epub 2012 Jun 28

    Article  PubMed  Google Scholar 

  14. Doba N, Reis DJ (1973) Acute fulminating neurogenic hypertension produced by brainstem lesions in the rat. Circ Res 32:584–593

    Article  CAS  PubMed  Google Scholar 

  15. Emanuele MA, Dorsch TR, Scarff TB, Lawrence AM (1981) Basilar artery aneurysm simulating pheochromocytoma. Neurology 31(12):1560–1561

    Article  CAS  PubMed  Google Scholar 

  16. Evans CH, Westfall V, Atuk NO (1972) Astrocytoma mimicking the features of pheochromocytoma. N Engl J Med 286(26):1397–1399

    Article  CAS  PubMed  Google Scholar 

  17. Frank H, Schobel HP, Heusser K, Geiger H, Fahlbusch R, Naraghi R (2009) Long-term results after microvascular decompression in essential hypertension. Stroke 40(1):47–51

    Article  PubMed  Google Scholar 

  18. Geiger H, Naraghi R, Schobel HP, Frank H, Sterzel RB, Fahlbusch R (1998) Decrease of blood pressure by ventrolateral medullary decompression in essential hypertension. Lancet 352(9126):446–449, Stroke. 2001 Dec 1;32(12):2950-5

    Article  CAS  PubMed  Google Scholar 

  19. Gómez-Esteban JC, Berganzo K, Tijero B, Barcena J, Zarranz JJ (2009) Orthostatic hypotension associated with an epidermoid tumor of the IV ventricle. J Neurol 256(8):1357–1359

    Article  PubMed  Google Scholar 

  20. Guyenet PG (2006) The sympathetic control of blood pressure. Nat Rev Neurosci 7(5):335–346

    Article  CAS  PubMed  Google Scholar 

  21. Heidel KM, Benarroch EE, Gené R, Klein F, Meli F, Saadia D et al (2002) Cardiovascular and respiratory consequences of bilateral involvement of the medullary intermediate reticular formation in syringobulbia. Clin Auton Res 12(6):450–456

    Article  CAS  PubMed  Google Scholar 

  22. Hsu CY, Hogan EL, Wingfield W, Webb JG, Perot PL Jr, Privitera PJ et al (1984) Orthostatic hypotension with brainstem tumors. Neurology 34:1137–1143

    Article  CAS  PubMed  Google Scholar 

  23. Ideguchi M, Kajiwara K, Yoshikawa K, Kato S, Ishihara H, Fujii M, Fujisawa H, Suzuki M (2010) Continuous hypertension and tachycardia after resection of a hemangioblastoma behind the dorsal medulla oblongata: relationship to sympathetic overactivity at the neurogenic vasomotor center. J Neurosurg 113(2):369–373. doi:10.3171/2009.10.JNS09504

    Article  PubMed  Google Scholar 

  24. Idiaquez J, Araya P, Benarroch E (2009) Orthostatic hypotension associated with dorsal medullary cavernous angioma. Acta Neurol Scand 119(1):45–48

    Article  CAS  PubMed  Google Scholar 

  25. Jannetta PJ, Gendell HM (1979) Clinical observations on etiology of essential hypertension. Surg Forum 30:431–432

    CAS  PubMed  Google Scholar 

  26. Jannetta PJ, Segal R, Wolfson SK (1985) Neurogenic hypertension: etiology and surgical treatment; observa- tions in 53 patients. Ann Surg 201:391–398

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Jordan D (2005) Vagal control of the heart: central serotonergic (5-HT) mechanisms. Exp Physiol 90(2):175–181

    Article  CAS  PubMed  Google Scholar 

  28. Kaplan NM (2001) Microvascular decompression: hype or hoax? Editorial comment. Stroke 32:2955–2956

    Google Scholar 

  29. Levy EI, Clyde B, McLaughlin MR, Jannetta PJ (1998) Microvascular decompression of the left lateral medulla oblongata for severe refractory neurogenic hypertension. Neurosurgery 43(1):1–6; discussion 6–9

    Article  CAS  PubMed  Google Scholar 

  30. Levy EI, Scarrow AM, Jannetta PJ (2001) Microvascular decompression in the treatment of hypertension: review and update. Surg Neurol 55(1):2–10; discussion 10–1

    Article  CAS  PubMed  Google Scholar 

  31. Low PA (1993) Autonomic nervous system function. J Clin Neurophysiol 10(1):14–27

    Article  CAS  PubMed  Google Scholar 

  32. Monge Argilés JA, Palacios Ortega F, Vila Sobrino JA, Bautista Prados J, Pérez Vicente JA, Morales Ortiz A, Palao SA (2000) Brainstem lesions decrease heart rate variability. Neurologia 15(4):158–163

    PubMed  Google Scholar 

  33. Morimoto S, Sasaki S, Miki S, Kawa T, Iotoh H, Nakata T et al (1997) Pulsatile compression of the rostral ventrolateral medulla in hypertension. Hypertension 29(part 2):514–518

    Article  CAS  PubMed  Google Scholar 

  34. Naraghi R, Fahlbusch R (1999) Microvascular decompression of the left lateral medulla oblongata for severe refractory neurogenic hypertension. Neurosurgery 45(4):955

    Article  CAS  PubMed  Google Scholar 

  35. Nathan MA, Reis DJ (1977) Chronic labile hypertension produced by lesions of the nucleus tractus solitarii in the cat. Circ Res 40:72–81

    Article  CAS  PubMed  Google Scholar 

  36. Navarro X (2016) Functional evaluation of peripheral nerve regeneration and target reinnervation in animal models: a critical overview. Eur J Neurosci 43(3):271–286. doi:10.1111/ejn.13033. Epub 2015 Aug 26. Review

  37. Pfeiffer RF (2003) Gastrointestinal dysfunction in parkinson’s disease. Lancet Neurol 2(2):107–116

    Article  PubMed  Google Scholar 

  38. Pickering TG (2007) Neurovascular compression of the medulla: can it cause neurogenic hypertension? J Clin Hypertens (Greenwich) 9(1):63–66

    Article  Google Scholar 

  39. Rhodes RH, Wightman HR (2000) Nucleus of the tractus solitarius metastasis: relationship to respiratory arrest? Can J Neurol Sci 27(4):328–332

    Article  CAS  PubMed  Google Scholar 

  40. Riedel G, Frewin DB, Gladstone L, Downey JA (1974) Orthostatic hypotension following surgery on brain-stem neoplasms: report of two cases. Arch Phys Med Rehabil 55(10):471–473

    CAS  PubMed  Google Scholar 

  41. Ruchoux MM, Gray F, Gherardi R, Schaeffer A, Comoy J, Poirier J (1986) Orthostatic hypotension from a cerebellar gangliocytoma (Lhermitte-Duclos disease). Case report. J Neurosurg 65(2):245–248

    Article  CAS  PubMed  Google Scholar 

  42. Sakakibara R, Mori M, Fukutake T, Kita K, Hattori T (1997) Orthostatic hypotension in a case with multiple sclerosis. Clin Auton Res 7:163–165

    Article  CAS  PubMed  Google Scholar 

  43. Saper CB (2002) The central autonomic nervous system: conscious visceral perception and autonomic pattern generation. Annu Rev Neurosci 25:433–469, Epub 2002 Mar 25

    Article  CAS  PubMed  Google Scholar 

  44. Schmitt H, Laubie M (1979) Destruction of the nucleus tractus solitarii in dogs: acute effects on blood pressure and haemodynamics, chronic effects on blood pressure: importance of the nucleus for the effects of drugs. In: Meyer P, Schmitt H (eds) Nervous System and Hypertension. Willey-Flammarion, New York, pp 173–201

    Google Scholar 

  45. Segal R, Gendell HM, Canfield D, Dujovny M, Jannetta PJ (1982) Hemodynamic changes induced by pulsatile compression of the ventrolateral medulla. Angiology 33(3):161–172

    Article  CAS  PubMed  Google Scholar 

  46. Sindou M, Mahmoudi M, Brînzeu A (2015) Hypertension of neurogenic origin: effect of microvascular decompression of the CNIX-X root entry/exit zone and ventrolateral medulla on blood pressure in a prospective series of 48 patients with hemifacial spasm associated with essential hypertension. J Neurosurg 31:1–9

    Article  Google Scholar 

  47. Straus D, Foster K, Zimmerman F, Frim D (2009) Chiari drop attacks: surgical decompression and the role of tilt table testing. Pediatr Neurosurg 45(5):384–389. doi:10.1159/000260909, Epub 2009 Nov 26

    Article  PubMed  Google Scholar 

  48. Thorén P (1979) Role of cardiac vagal C-fibers in cardiovascular control. Rev Physiol Biochem Pharmacol 86:1–94

    Article  PubMed  Google Scholar 

  49. Watters MR, Burton BS, Turner GE, Cannard KR (1996) MR screening for brain stem compression in hypertension. AJNR Am J Neuroradiol 17(2):217–221

    CAS  PubMed  Google Scholar 

  50. Wörner BA, Rahim T, Lange M, Fink U, Oeckler R (2002) Long-lasting improvement of arterial hypertension after surgical treatment of a foramen magnum meningioma: case report. Surg Neurol 58(3-4):189–192; discussion 193

    Article  PubMed  Google Scholar 

  51. Yagil Y, Futterweit W, Krakoff LR, Rubin H, Weinrauch H (1989) Cerebellar tumor causing hypertensive crisis and simulating pheochromocytoma and Cushing’s syndrome. Mt Sinai J Med 56(1):56–58

    CAS  PubMed  Google Scholar 

  52. Yamashita A, Hirayama M, Koike Y, Nukata M, Hashizume M, Takahashi A (1996) Orthostatic hypotension caused by a localised dorsal medullary tumour. J Neurol Neurosurg Psychiatry 61(1):118–119

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Zaidi HA, Awad AW, Chowdhry SA, Fusco D, Nakaji P, Spetzler RF (2015) Microvascular decompression for hemifacial spasm secondary to vertebrobasilar dolichoectasia: surgical strategies, technical nuances and clinical outcomes. J Clin Neurosci 22(1):62–68. doi:10.1016/j.jocn.2014.09.008, Epub 2014 Dec 12

    Article  PubMed  Google Scholar 

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Conflict of Interest Statement

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Regional University Hospital of Málaga, Avenida Carlos Haya s/n, 29010, Málaga, Spain

    A. Martín-Gallego, L. González-García, A. Carrasco-Brenes, M. Segura-Fernández-Nogueras, A. Delgado-Babiano, A. Ros-Sanjuán, L. Romero-Moreno, M. Domínguez-Páez & M. A. Arráez-Sánchez

  2. Department of Autonomic Nervous System, CIMES, University of Málaga Foundation (FGUMA), Malaga, Spain

    M. S. Dawid-Milner

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  1. A. Martín-Gallego
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Corresponding author

Correspondence to A. Martín-Gallego .

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Editors and Affiliations

  1. Institute of Neurosurgery Medical School, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

  2. Dept. of Neurosurgery, Christian-Albrechts-University of Kiel, Kiel, Germany

    H. Maximilian Mehdorn

  3. Department of Neurological Surgery, Nihon University, Tokyo, Japan

    Yoichi Katayama

  4. Medical Faculty University of Münster, Münster, Germany

    Klaus R. H. von Wild

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Martín-Gallego, A. et al. (2017). Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View. In: Visocchi, M., Mehdorn, H.M., Katayama, Y., von Wild, K.R.H. (eds) Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement, vol 124. Springer, Cham. https://doi.org/10.1007/978-3-319-39546-3_34

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  • DOI: https://doi.org/10.1007/978-3-319-39546-3_34

  • Publisher Name: Springer, Cham

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