Hernando Rafael, Rafaela Mego
CaseRepClinPractRev 2006; 7:52-55
Background: Since 1973 we known that the vascular decompression of the left rostral ventrolateral medulla and the revascularization (since 1997) of the posterior hypothalamic nuclei, both of them surgical
procedures can normalize neurogenic hypertension.
Case Report: A 55-year-old woman suffered a 4-month history of vertigo, vomiting and arterial hypertension.Four days before her admission, she suddenly presented headache, left facial drowsiness, neck pain and gait disturbances. The examination revealed besides this, blood pressure of 160/95
mm Hg, pulse 60 per minute, respiratory frequency 15 per minute, horizontal nystagmus and cerebellar dysfunction. A CT scans showed an expansible mass in the left crebellar hemisphere. A partial surgical removal of the cerebellum due to infectious process was performed using a suboccipital craniotomy.
Neurological improvement began since the first day after surgery. Likewise, the pulse,the respiratory
frequency and the arterial hypertension were normalized since the immediate postoperative.
Conclusions: This neurosurgical findings confirm that ischemic neurons in the left A1/C1 cell column of the
medulla oblongata is responsible of neurogenic arterial hypertension.
Keywords: Cerebellar infectious process, Ischemia, Medulla Oblongata, Neurogenic hypertension