This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hohenbleicher, H. Articles by Sharma, A. M. Search for Related Content PubMed PubMed Citation Articles by Hohenbleicher, H. Articles by Sharma, A. M. Related Collections Other etiology CT and MRI CV surgery: aortic and vascular disease Computerized tomography and Magnetic Resonance Imaging Autonomic, reflex, and neurohumoral control of circulation Other Vascular biology

(Hypertension. 2001;37:176.)
© 2001 American Heart Association, Inc.

Scientific Contributions

Neurovascular Contact of Cranial Nerve IX and X Root-Entry Zone in Hypertensive Patients

Henriette Hohenbleicher; Stephan A. Schmitz; Hans-Christian Koennecke; Ralf Offermann; Jens Offermann; Helen Zeytountchian; Karl-Jürgen Wolf; Armin Distler; Arya M. Sharma

From the Department of Internal Medicine (H.H., R.O., J.O., H.Z., A.D., A.M.S.), Division of Endocrinology and Nephrology, the Department of Radiology (S.A.S., K.-J.W.), and the Department of Neurology (H.-C.K.), Universitätsklinikum Benjamin Franklin, Berlin, Germany.

Correspondence to Prof Arya M. Sharma, Abteilung für Nephrologie und Hypertensiologie, Franz-Volhard Klinik–Charité, Wiltbergstrasse 50, 13122 Berlin-Buch, Germany. E-mail sharma{at}fvk-berlin.de

Abstract—Neurovascular contact of the left rostral ventrolateral medulla has been implicated in the pathogenesis of "essential" hypertension, and recent intervention studies suggest that surgical decompression of the ventrolateral medulla lowers blood pressure in these patients. We assessed the prevalence of this vascular anomaly in patients with essential hypertension by using an advanced MRI technique. We performed MRI of the brain stem in 125 hypertensive patients and in 105 age-matched, sex-matched, and body mass index–matched normotensive control subjects. Imaging of the root-entry zone of cranial nerves IX and X was performed by combining a high-resolution 3D constructive interference in steady-state sequence with a flow-sensitive time-of-flight technique, and images were independently assessed by 4 readers using predefined criteria. Left-sided neurovascular contact was found in 23% of the hypertensive patients and in 16% of the normotensive individuals (P=0.12). Blood pressure level, heart rate, and number of antihypertensive medications in treated hypertensive patients were similar among patients with positive, borderline, and negative brain stem findings. Our findings cast doubt on the importance of left-sided neurovascular contact as a frequent cause of essential hypertension or as a major factor determining the severity of hypertension in patients with this anomaly.

Key Words: nervous system • hypertension, essential • magnetic resonance imaging • hypertension, neurogenic • brain

This article has been cited by other articles:

				J. S. Nicholas, S. J. D'Agostino, and S. J. Patel Arterial Compression of the Retro-Olivary Sulcus of the Ventrolateral Medulla in Essential Hypertension and Diabetes Hypertension, October 1, 2005; 46(4): 982 - 985. [Abstract] [Full Text] [PDF]

				V. Biousse, N. J. Newman, G. Y. Chang, S. Cruz-Flores, F. de Assis Aquino Gondim, and E. C. Leira Brainstem involvement in hypertensive encephalopathy: Clinical and radiological findings Neurology, November 9, 2004; 63(9): 1759 - 1760. [Full Text] [PDF]

				J. Zizka, J. Ceral, P. Elias, J. Tintera, L. Klzo, M. Solar, and L. Straka Vascular Compression of Rostral Medulla Oblongata: Prospective MR Imaging Study in Hypertensive and Normotensive Subjects Radiology, January 1, 2004; 230(1): 65 - 69. [Abstract] [Full Text] [PDF]

				H. Frank, H.P. Schobel, K. Heusser, H. Geiger, R. Fahlbusch, R. Naraghi, and N. M. Kaplan Long-Term Results After Microvascular Decompression in Essential Hypertension Editorial Comment Stroke, December 1, 2001; 32(12): 2950 - 2955. [Abstract] [Full Text] [PDF]

				C. Menzel, H. Geiger, A. M. Sharma, and H. Hohenbleicher Neurovascular Contact of Cranial Nerve IX and X Root-Entry Zone in Hypertensive Patients Response Hypertension, June 1, 2001; 37 (6): e25 - e25. [Full Text] [PDF]