title: Observations of changes of blood pressure before and after neurosurgical decompression in hypertensive patients with different types of neurovascular compression of brain stem.
abstract: OBJECTIVE
  The neurovascular pulsatile compression of the rostral ventrolateral medulla can be divided into different subtypes. The posterior inferior cerebellar artery and/or vertebral artery can compress either the rostral ventrolateral medulla or the cranial nerves IX and X or both and on left, right or both sides.
  
  
  METHODS
  It was retrospectively investigated whether the types of neurovascular compression can influence blood pressure values. Data from 13 resistant hypertensive patients after decompression were investigated.
  
  
  RESULTS
  Six patients had 2 compressions, two had only medulla compression, four had only nerve compression on the left side and one had 2 compressions on both sides. There was no correlation between the types of compression and the levels of blood pressure, either before or after the decompression. Both, systolic and diastolic blood pressures and pulse pressure also decreased in all cases after the decompression but the change was significant only in the group with 2 compressions on the left side.
  
  
  CONCLUSIONS
  According to our data, in a severe hypertension not responding to conventional antihypertensive therapy, the surgical decompression of the brain stem independently of the types of neurovascular compression could guarantee a decrease of blood pressure and improved sensitivity to antihypertensive medication.
authors.affiliation: First Department of Medicine, University of Szeged, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Legrady
authors.forename: Erika
authors.initials: E
authors.lastname: Voros
authors.forename: Dora
authors.initials: D
authors.lastname: Bajcsi
authors.forename: Imola
authors.initials: I
authors.lastname: Fejes
authors.forename: Pal
authors.initials: P
authors.lastname: Barzo
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Abraham
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001933:Brain Stem / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D019299:Decompression, Surgical / Q000639:trends; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000639:trends; D012189:Retrospective Studies