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Biomed Imaging Interv J · Jan 2007
Autonomic neurosurgery: from microvascular decompression to image guided stimulation.
- Eac Pereira and Al Green.
- Oxford Functional Neurosurgery, Department of Neurosurgery, Radcliffe Infirmary, United Kingdom.
- Biomed Imaging Interv J. 2007 Jan 1; 3 (1): e14.
AbstractThe paper reviews mechanisms underlying autonomic disorders, with a focus on cardiovascular dysfunction. Neurosurgical approaches are described for medically refractory hypertension and orthostatic hypotension. After review of microvascular decompression of the rostral ventrolateral medulla, stereotactic CT and MRI guided deep brain stimulation of the periaqueductal grey matter (PAG) is evaluated. Results are presented from patient studies showing reductions in blood pressure with ventral PAG stimulation and increases in blood pressure with dorsal PAG stimulation. A rationale for the treatment of autonomic disorders by neurosurgical intervention is discussed.
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