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Related Experiment Videos

MR screening for brain stem compression in hypertension

M R Watters1, B S Burton, G E Turner

  • 1Department of Neurology, Tripler Army Medical Center, Honolulu, Hawaii, USA.

AJNR. American Journal of Neuroradiology
|February 1, 1996
PubMed
Summary

Vascular compression of cranial nerves IX and X in the lateral medulla is common in both hypertensive and normotensive individuals. MR imaging findings do not correlate with hypertension severity or end-organ damage, making screening unwarranted in asymptomatic patients.

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Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Neurovascular compression of cranial nerves IX and X is hypothesized by some to cause neurogenic hypertension.
  • Magnetic Resonance (MR) imaging is a key diagnostic tool for visualizing neurovascular relationships.

Purpose of the Study:

  • To evaluate the clinical utility of MR imaging in screening for vascular compression of the lateral medulla.
  • To determine if MR-detected vascular compression is associated with essential hypertension or its end-organ effects.

Main Methods:

  • MR images and clinical data from 120 adults (60 hypertensive, 60 normotensive) without symptomatic cranial neuralgias were analyzed.
  • The root entry zone of cranial nerves IX and X was assessed for vascular compression by the vertebral artery or its branches.

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  • Compression was graded (I-III) based on proximity and effect on the brainstem; hypertensive patients' cardiac and renal status were also evaluated.

    • Main Results:

    • Vascular compression was observed in 57% of hypertensive patients and 55% of normotensive patients, with no statistically significant difference between groups.
    • MR imaging findings, including compression grade, did not correlate with the presence or severity of hypertension.
    • Compression severity did not predict cardiac (left axis deviation, left ventricular hypertrophy) or renal (proteinuria) end-organ damage in hypertensive patients.

    Conclusions:

    • Vascular compression of the lateral medulla is a common finding and not a sufficient cause for essential hypertension.
    • MR imaging of the lateral medulla is not clinically useful for screening hypertensive patients without symptomatic cranial neuralgias.
    • The presence or severity of vascular compression on MR images does not predict common end-organ complications in hypertensive individuals.