Therapeutic evaluation of left medullary microvascular decompression on neurogenic hypertension

Abstract

Objective To investigate the effect of microvascular decompression (MVD) in patients with severe hypertension with microvascular comprssion(MVC) on blood pressure.Methods From September 2009 to June 2011,thirty-six cases of cranial nerve diseases who also suffered with primary hypertension before MVD operation,and 12 cases suffered with hypertension of the left cranial nerve disease received MVD operation on the left ventrolateral medulla.The BP and hormone levels of these cases were compared before and after the operation to evaluate the effective on BP of MVD,and to observed the BP levels in 6-25months.Results Twelve cases received MVD operation on the left ventrolateral medulla and the result showed:three cases were cured,five cases improved,three cases were effective,however,one cases were invalid.Levels of serum angiotensin A2 and aldosterone went down after the operation (P ＜ 0.05).Twenty-four cases did not receive MVD operation on the left ventrolateral medulla and the result showed:three cases were cured,six cases improved eight cases were effective,seven cases were invalid.Conclusion A more significant improvement in follow-up shown in patients with high blood pressure.It was pathogenesis of neurogenic hypertension that oppressing cranial nerve roots and the medulla oblongata by abnormal vascular loop leads to long term aching stimulation and emotional stress,MVD operation on the left ventrolateral medulla is an effective treatment of neurogenic hypertension. Key words: Hypertension; Cranial nerve; Microvascular decompression; Microsurgical technique; Medulla