PDF(Pubmed)
Abstract：
Neurovascular compression of the rostral ventrolateral medulla (RVLM) has been described as a possible cause of refractory essential hypertension. We present the case of a patient affected by episodes of severe paroxysmal hypertension, some episodes associated with vago-glossopharyngeal neuralgia. Classical secondary forms of hypertension were excluded. Imaging revealed a neurovascular conflict between the posterior inferior cerebellar artery (PICA) and the ventrolateral medulla at the level of the root entry zone of the ninth and tenth cranial nerves (CN IX-X REZ). A MVD of a conflict between the PICA and the RVLM and adjacent CN IX-X REZ was performed, resulting in reduction of the frequency and severity of the episodes. Brain MRI should be performed in cases of paroxysmal hypertension. MVD can be considered in selected patients.
摘要：
延髓腹外侧神经血管压迫（RVLM）已被描述为难治性原发性高血压的可能原因。我们介绍了一例严重阵发性高血压发作的患者，一些与vago-舌咽神经痛相关的发作。排除了经典的继发性形式的高血压。影像学显示，在第九和第十颅神经（CNIX-XREZ）的根进入区水平，小脑后下动脉（PICA）与延髓腹外侧之间存在神经血管冲突。对PICA和RVLM与相邻的CNIX-XREZ之间的冲突进行了MVD，导致发作的频率和严重程度降低。在阵发性高血压的情况下，应进行脑部MRI。可以在选定的患者中考虑MVD。
