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Autonomic neurosurgery: from microvascular decompression to image guided stimulation
1Oxford Functional Neurosurgery, Department of Neurosurgery, Radcliffe Infirmary, United Kingdom.
Biomedical Imaging and Intervention Journal
|May 27, 2011
Summary
This study explores neurosurgical treatments for autonomic disorders, like hypertension and orthostatic hypotension. Deep brain stimulation of the periaqueductal grey matter shows potential for managing cardiovascular dysfunction.
Area of Science:
- Neurology
- Neurosurgery
- Cardiovascular Physiology
Background:
- Autonomic disorders significantly impact cardiovascular function.
- Medically refractory hypertension and orthostatic hypotension present therapeutic challenges.
Purpose of the Study:
- To review mechanisms of autonomic disorders, focusing on cardiovascular dysfunction.
- To evaluate neurosurgical interventions for these conditions.
Main Methods:
- Review of microvascular decompression techniques.
- Assessment of deep brain stimulation (DBS) of the periaqueductal grey matter (PAG) using CT and MRI guidance.
Main Results:
- Ventral PAG stimulation demonstrated blood pressure reduction.
- Dorsal PAG stimulation resulted in blood pressure increase.
- Neurosurgical intervention offers a rationale for treating autonomic disorders.
Conclusions:
- Deep brain stimulation of the PAG is a viable neurosurgical approach.
- Targeted PAG stimulation can modulate blood pressure in autonomic dysfunction.
- Neurosurgery provides novel treatment avenues for complex autonomic disorders.
