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The spectrum of magnetic resonance imaging findings in hypertension-related neurovascular compression

  • Diagnostic Neuroradiology
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Abstract

Hypertension (HTN) has been controversially related to neurovascular compression (NVC) at the rostral ventrolateral (RVL) medulla in anatomical, surgical, and radiological reports. Our objective was to investigate the association between primary HTN and signs of NVC at the medulla oblongata on magnetic resonance imaging (MRI) and to explore a new classification based on image criteria. Subjects with (n=64) and without (n=29) HTN were studied. Three-millimeter slices, with 1-mm intervals in between, were performed on T2-weighted images in axial and coronal views. Attention was focused on the relationship between the upper medulla and the surrounding arteries. The findings were divided into three categories: 1) non-NVC: absence of signs of NVC, 2) NVC type I: an artery in contact with the RVL medulla but not compressing it, and 3) NVC type II: evident compression of the RVL medulla by an artery. Signs of NVC were observed in 65.7% (42/64) of the HTN group (type I: 39.1%, 25/42 patients; type II: 26.6%, 17/42 patients). Among the normotensive subjects, 27.6% (8/29) had signs of NVC; only one (3.3%) of these had NVC type II (evident compression), and the rest were NVC type I. We conclude that the presence of NVC at the RVL medulla on MRI is related to HTN. More importantly, the finding of frank compression (NVC type II) is present almost exclusively in hypertensive subjects; only one individual (3.3% of our normotensive population) had NVC type II.

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Acknowledgements

Financial support was provided by Fundação Zerbini and FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo).

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Authors and Affiliations

  1. Heart Institute (InCor) and Discipline of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil

    Mauricio Michalak Sendeski

  2. Heart Institute (InCor-HC.FMUSP), University of São Paulo Medical School, São Paulo, Brazil

    Fernanda Marciano Consolim-Colombo & Eduardo Moacyr Krieger

  3. Department of Radiology (HC.FMUSP), University of São Paulo Medical School, São Paulo, Brazil

    Cláudia da Costa Leite

  4. Institut für Physiologie-Herz-Kreislaufabteilung, Tucholskystrasse 2, Berlin, 10177, Germany

    Mauricio Michalak Sendeski

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  1. Mauricio Michalak Sendeski
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  2. Fernanda Marciano Consolim-Colombo
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  3. Eduardo Moacyr Krieger
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  4. Cláudia da Costa Leite
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Correspondence to Mauricio Michalak Sendeski.

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Sendeski, M.M., Consolim-Colombo, F.M., Krieger, E.M. et al. The spectrum of magnetic resonance imaging findings in hypertension-related neurovascular compression. Neuroradiology 48, 21–25 (2006). https://doi.org/10.1007/s00234-005-0005-8

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  • DOI: https://doi.org/10.1007/s00234-005-0005-8

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