Ventrolateral medullary compression by vascular contact in primary hemifacial spasm: a radiological analysis.

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Title: Ventrolateral medullary compression by vascular contact in primary hemifacial spasm: a radiological analysis.
Authors: Anudeep, D. D. S. (AUTHOR), Karthik, K. (AUTHOR), Holla, Vikram V. (AUTHOR), Kamble, Nitish (AUTHOR), Yadav, Ravi (AUTHOR), Pal, Pramod Kumar (AUTHOR), Mahale, Rohan R. (AUTHOR)
Source: Neurological Sciences. Oct2024, Vol. 45 Issue 10, p4857-4861. 5p.
Subjects: Magnetic resonance imaging, Vertebral artery, Hypertension, Spasms, Cross-sectional method
Abstract: Background: The neurovascular conflict (NVC) causing hemifacial spasm (HFS) can also cause compression of ventrolateral medulla (VLM) which contains the central sympathetic neurons. VLM compression has been associated with hypertension. Whether the VLM compression in HFS patients is associated with hypertension is not clear. Objective: To determine the frequency, severity of VLM compression and its association with hypertension in HFS patients. Methods: A cross-sectional, hospital-based, case control study and recruited 120 study subjects (50 cases of primary HFS, 30 hypertensive and 40 normotensive age-, sex- matched controls). The VLM compression was assessed in magnetic resonance imaging Constructive Interference in Steady State (CISS) 3D sequences. Results: Hypertension was present in 30 cases (60%). Six patients with HFS (20%) were detected to be hypertensive after the onset of HFS. VLM compression was seen in 24 cases (48%), 7 hypertensive controls (23.3%) and 5 normotensive controls (10%) (p = 0.03). Twenty-four patients with hypertension had VLM compression and remaining 6 patients with hypertension did not have VLM compression (80% vs 20%; p = 0.02). Normotensive patients did not have VLM compression. Vertebral artery was the most common artery causing VLM compression (22 patients; 7 hypertensive and 5 normotensive controls). Conclusion: VLM compression is more common in HFS patients as compared to hypertensive and normotensive controls. It is more common in hypertensive HFS patients in comparison with normotensive HFS patients. Microvascular decompression is an option in hypertensive HFS patients with VLM compression if the hypertension is medically refractory. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Ventrolateral medullary compression by vascular contact in primary hemifacial spasm: a radiological analysis.
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  Data: <searchLink fieldCode="AR" term="%22Anudeep%2C+D%2E+D%2E+S%2E%22">Anudeep, D. D. S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Karthik%2C+K%2E%22">Karthik, K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Holla%2C+Vikram+V%2E%22">Holla, Vikram V.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kamble%2C+Nitish%22">Kamble, Nitish</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yadav%2C+Ravi%22">Yadav, Ravi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pal%2C+Pramod+Kumar%22">Pal, Pramod Kumar</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mahale%2C+Rohan+R%2E%22">Mahale, Rohan R.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Oct2024, Vol. 45 Issue 10, p4857-4861. 5p.
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  Data: <searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Vertebral+artery%22">Vertebral artery</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension%22">Hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Spasms%22">Spasms</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink>
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  Data: Background: The neurovascular conflict (NVC) causing hemifacial spasm (HFS) can also cause compression of ventrolateral medulla (VLM) which contains the central sympathetic neurons. VLM compression has been associated with hypertension. Whether the VLM compression in HFS patients is associated with hypertension is not clear. Objective: To determine the frequency, severity of VLM compression and its association with hypertension in HFS patients. Methods: A cross-sectional, hospital-based, case control study and recruited 120 study subjects (50 cases of primary HFS, 30 hypertensive and 40 normotensive age-, sex- matched controls). The VLM compression was assessed in magnetic resonance imaging Constructive Interference in Steady State (CISS) 3D sequences. Results: Hypertension was present in 30 cases (60%). Six patients with HFS (20%) were detected to be hypertensive after the onset of HFS. VLM compression was seen in 24 cases (48%), 7 hypertensive controls (23.3%) and 5 normotensive controls (10%) (p = 0.03). Twenty-four patients with hypertension had VLM compression and remaining 6 patients with hypertension did not have VLM compression (80% vs 20%; p = 0.02). Normotensive patients did not have VLM compression. Vertebral artery was the most common artery causing VLM compression (22 patients; 7 hypertensive and 5 normotensive controls). Conclusion: VLM compression is more common in HFS patients as compared to hypertensive and normotensive controls. It is more common in hypertensive HFS patients in comparison with normotensive HFS patients. Microvascular decompression is an option in hypertensive HFS patients with VLM compression if the hypertension is medically refractory. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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