Ventrolateral Compression of the Brain Stem in Essential Hypertension: MR Angiography Study

Abstract

Our purpose was to evaluate neurovascular compression at the level of ventrolateral medulla and NVC with the IXth and the Xth cranial nerves in patients with essential hypertension and in healthy volunteers using high resoluted Spoiled Recalled Gradient Echo (SPGR) sequences, allowing the detection of stationary tissues and moving spins. Thirty patients (19 men and 11 women) with essential hypertension were examined. Patient's ages ranged from 24 to 64 years-old (mean age was 48 y.o.). Patients older than 65 were excluded. The average of systolic blood-pressure of hypertensive patients was 183 ± 10 mmHg, while the diastolic pressure was 98 ± 10.5 mmHg. In conclusion, we consider axial single partitions from a three-dimensional TOF MRA sequence ideal to demonstrate both vascular and neural components of NVC. NVC could explain essential hypertension disease in a significant percentage of patients, even though true idiopathic hypertension - probably less frequent than believed- exists.