Continuous hypertension and tachycardia after resection of a hemangioblastoma behind the dorsal medulla oblongata: relationship to sympathetic overactivity at the neurogenic vasomotor center.
A very rare case of continuous hypertension and tachycardia after excision of a cerebellar hemangioblastoma at the dorsal medulla oblongata is presented. This 21-year-old man was admitted to the authors' hospital with a headache and dizziness. Radiological examination revealed a tumor located behind the dorsal medulla oblongata and compressing it substantially. The tumor was completely resected, but after the surgery the patient experienced prolonged hypertension and tachycardia. Postoperative MR imaging showed a small injury at the dorsocaudal medulla that was located at the caudal site of the nucleus of the tractus solitarius (NTS). Because the NTS has been reported to play a central role in cardiovascular regulation along with the rostral ventrolateral medulla, the authors considered it possible that the NTS injury was the cause of the prolonged elevation of sympathetic tone.
Ideguchi
Makoto
M
Department of Neurosurgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan. ideguchi@yamaguchi-u.ac.jp
Kajiwara
Koji
K
Yoshikawa
Koichi
K
Kato
Shoichi
S
Ishihara
Hideyuki
H
Fujii
Masami
M
Fujisawa
Hirosuke
H
Suzuki
Michiyasu
M
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D017704:Baroreflex; D020295:Brain Stem Neoplasms / Q000473:pathology / Q000601:surgery*; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D004110:Diltiazem / Q000008:administration & dosage; D018325:Hemangioblastoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology; D009025:Morpholines / Q000008:administration & dosage; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D017552:Solitary Nucleus / Q000473:pathology; D013610:Tachycardia / Q000188:drug therapy / Q000209:etiology*; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives; D014666:Vasomotor System / Q000473:pathology; D055815:Young Adult
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009025:Morpholines; C077049:landiolol; D014508:Urea; D004110:Diltiazem