Essential hypertension and neurovascular compression at the ventrolateral medulla oblongata: MR evaluation.
OBJECTIVE
To investigate, using MR imaging, neurovascular compression at the ventrolateral medulla oblongata in patients with essential hypertension.


METHODS
Thirty-two patients with essential hypertension (57.6 +/- 7 years of age), 6 patients with secondary hypertension (56.7 +/- 10.3 years of age), and 18 control subjects (50.5 +/- 11 years of age) were evaluated. Transaxial three-dimensional fast low angle shot images were obtained (38/6/1 [repetition time/echo time/excitations]). The center of a 40-mm-thick slab (16 partitions) was placed at the pontomedullary junction. We evaluated the relationships between the upper ventrolateral medulla and the vertebral arteries and branches identified by their flow-related hyperintensities in each group.


RESULTS
In the essential hypertension group, 29 (90.6%) of 32 cases showed neurovascular compression. Of those, 22 demonstrated neurovascular compression on the left side, 3 on both sides, and 4 on the right side. In the control group, 4 cases of 18 showed neurovascular compression. In the secondary hypertension group, 1 of 6 cases showed neurovascular compression. The rates of observed neurovascular compression between controls and essential hypertension group were statistically significant.


CONCLUSIONS
We found a close correlation between essential hypertension and neurovascular compression at the ventrolateral medulla oblongata on the left side. MR with a 3-D fast low-angle shot sequence has acceptable spatial resolution and depicts blood vessels simultaneously by flow-related phenomena.
Akimura
T
T
Department of Neurosurgery, Konan Sentohiru Hospital, Yamaguchi, Japan.
Furutani
Y
Y
Jimi
Y
Y
Saito
K
K
Kashiwagi
S
S
Kato
S
S
Ito
H
H
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology*; D008875:Middle Aged; D014711:Vertebral Artery / Q000473:pathology