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Erschienen in: Child's Nervous System 2/2021

20.05.2020 | Case Report

Chiari I malformation with neurogenic hypertension after suboccipital decompression

verfasst von: Abdulelah A. Alluhaybi, Sarah Bin Abdulqader, Turki Alanazi, Khalid Altuhayni, Ayman Albanyan

Erschienen in: Child's Nervous System | Ausgabe 2/2021

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Abstract

Patients with Chiari I malformations have a spectrum of symptoms related to craniocervical structural compression. Neurogenic hypertension has been reported in some patients with this disorder, with resolution of hypertension after suboccipital decompressions in some cases. The pathophysiology of neurogenic hypertension in these patients is thought to be related to ventrolateral medullary compression. The important role of the ventrolateral medulla in blood pressure control has been studied extensively. In this report, we present the case of a pediatric patient diagnosed with a Chiari I malformation who developed hypertension after a suboccipital decompression. We believe that this case demonstrates the important role of the ventrolateral medulla in neurogenic hypertension.
Literatur
1.
Zurück zum Zitat Arnautovic A, Splavski B, Boop FA, Arnautovic KI (2015) Pediatric and adult Chiari malformation type I surgical series 1965–2013: a review of demographics, operative treatment, and outcomes. J Neurosurg Pediatr 15:161–177CrossRef Arnautovic A, Splavski B, Boop FA, Arnautovic KI (2015) Pediatric and adult Chiari malformation type I surgical series 1965–2013: a review of demographics, operative treatment, and outcomes. J Neurosurg Pediatr 15:161–177CrossRef
2.
Zurück zum Zitat Bindu B, Mitra R, Singh GP, Phalak M (2018) New onset persistent refractory hypertension after medulloblastoma excision in children—an indicator of poor prognosis: a case series. J Pediatr Neurosci 13:337–339CrossRef Bindu B, Mitra R, Singh GP, Phalak M (2018) New onset persistent refractory hypertension after medulloblastoma excision in children—an indicator of poor prognosis: a case series. J Pediatr Neurosci 13:337–339CrossRef
3.
Zurück zum Zitat Ciriello J, Caverson MM, Polosa C (1986) Function of the ventrolateral medulla in the control of the circulation. Brain Res 11:359–391CrossRef Ciriello J, Caverson MM, Polosa C (1986) Function of the ventrolateral medulla in the control of the circulation. Brain Res 11:359–391CrossRef
4.
Zurück zum Zitat de Almeida Holanda MM, Ferreira CD, Rocha AB, Santos RHP, Neto NGP, Boguszewski MCS (2012) Chiari I malformation with neurogenic hypertension: case report. Childs Nerv Syst 28:1985–1987CrossRef de Almeida Holanda MM, Ferreira CD, Rocha AB, Santos RHP, Neto NGP, Boguszewski MCS (2012) Chiari I malformation with neurogenic hypertension: case report. Childs Nerv Syst 28:1985–1987CrossRef
5.
Zurück zum Zitat Gajjar D, Egan B, Curè J, Rust P, VanTassel P, Patel SJ (2000) Vascular compression of the rostral ventrolateral medulla in sympathetic mediated essential hypertension. Hypertension 36:78–82CrossRef Gajjar D, Egan B, Curè J, Rust P, VanTassel P, Patel SJ (2000) Vascular compression of the rostral ventrolateral medulla in sympathetic mediated essential hypertension. Hypertension 36:78–82CrossRef
6.
Zurück zum Zitat Garland EM, Anderson JC, Black BK, Kessler RM, Konrad PE, Robertson D (2002) No increased herniation of the cerebellar tonsils in a group of patients with orthostatic intolerance. Clin Auton Res 12:472–476CrossRef Garland EM, Anderson JC, Black BK, Kessler RM, Konrad PE, Robertson D (2002) No increased herniation of the cerebellar tonsils in a group of patients with orthostatic intolerance. Clin Auton Res 12:472–476CrossRef
7.
Zurück zum Zitat Ghali MGZ (2017) The brainstem network controlling blood pressure: an important role for pressor sites in the caudal medulla and cervical spinal cord. J Hypertens 35:1938–1947CrossRef Ghali MGZ (2017) The brainstem network controlling blood pressure: an important role for pressor sites in the caudal medulla and cervical spinal cord. J Hypertens 35:1938–1947CrossRef
8.
Zurück zum Zitat Ghasemi M, Golabchi K, Shaygannejad V, Rezvani M (2011) Is Chiari malformation a cause of systemic hypertension and sinus bradycardia? A case report and literature review. J Res Med Sci 16:115–118PubMedPubMedCentral Ghasemi M, Golabchi K, Shaygannejad V, Rezvani M (2011) Is Chiari malformation a cause of systemic hypertension and sinus bradycardia? A case report and literature review. J Res Med Sci 16:115–118PubMedPubMedCentral
9.
Zurück zum Zitat Greenberg JK, Yarbrough CK, Radmanesh A, Godzik J, Yu M, Jeffe DB, Smyth MD, Park TS, Piccirillo JF, Limbrick DD (2015) The Chiari Severity Index: a preoperative grading system for Chiari malformation type 1. Neurosurgery 76:279–285CrossRef Greenberg JK, Yarbrough CK, Radmanesh A, Godzik J, Yu M, Jeffe DB, Smyth MD, Park TS, Piccirillo JF, Limbrick DD (2015) The Chiari Severity Index: a preoperative grading system for Chiari malformation type 1. Neurosurgery 76:279–285CrossRef
10.
Zurück zum Zitat Ideguchi M, Kajiwara K, Yoshikawa K, Kato S, Ishihara H, Fujii M, Fujisawa H, Suzuki M (2010) Continuous hypertension and tachycardia after resection of a hemangioblastoma behind the dorsal medulla oblongata: relationship to sympathetic overactivity at the neurogenic vasomotor center. J Neurosurg 113:369–373CrossRef Ideguchi M, Kajiwara K, Yoshikawa K, Kato S, Ishihara H, Fujii M, Fujisawa H, Suzuki M (2010) Continuous hypertension and tachycardia after resection of a hemangioblastoma behind the dorsal medulla oblongata: relationship to sympathetic overactivity at the neurogenic vasomotor center. J Neurosurg 113:369–373CrossRef
11.
Zurück zum Zitat Idiaquez J, Fadic R, Mathias CJ (2011) Transient orthostatic hypertension after partial cerebellar resection. Clin Auton Res 21:57–59CrossRef Idiaquez J, Fadic R, Mathias CJ (2011) Transient orthostatic hypertension after partial cerebellar resection. Clin Auton Res 21:57–59CrossRef
12.
Zurück zum Zitat Jannetta PJ, Gendell HM (1979) Clinical observations on etiology of essential hypertension. Surg Forum 30:431–432.5PubMed Jannetta PJ, Gendell HM (1979) Clinical observations on etiology of essential hypertension. Surg Forum 30:431–432.5PubMed
13.
Zurück zum Zitat Jarski P, Zimny M, Linart M, Kozłowska Z, Mandera M (2019) Results of the surgical treatment in children with Chiari malformation type I. Childs Nerv Syst 35:1911–1914CrossRef Jarski P, Zimny M, Linart M, Kozłowska Z, Mandera M (2019) Results of the surgical treatment in children with Chiari malformation type I. Childs Nerv Syst 35:1911–1914CrossRef
14.
Zurück zum Zitat Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS (2000) Asymptomatic Chiari type I malformations identified on magnetic resonance imaging. J Neurosurg 92:920–926CrossRef Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS (2000) Asymptomatic Chiari type I malformations identified on magnetic resonance imaging. J Neurosurg 92:920–926CrossRef
15.
Zurück zum Zitat Morimoto S, Sasaki S, Takeda K, Furuya S, Naruse S, Matsumoto K, Higuchi T, Saito M, Nakagawa M (1999) Decreases in blood pressure and sympathetic nerve activity by microvascular decompression of the rostral ventrolateral medulla in essential hypertension. Stroke 30:1707–1710CrossRef Morimoto S, Sasaki S, Takeda K, Furuya S, Naruse S, Matsumoto K, Higuchi T, Saito M, Nakagawa M (1999) Decreases in blood pressure and sympathetic nerve activity by microvascular decompression of the rostral ventrolateral medulla in essential hypertension. Stroke 30:1707–1710CrossRef
16.
Zurück zum Zitat Naderi S, Acar F, Acar G, Men S (2005) Resolution of neurogenic arterial hypertension after suboccipital decompression for Chiari malformation: case report. J Neurosurg 102:1147–1150CrossRef Naderi S, Acar F, Acar G, Men S (2005) Resolution of neurogenic arterial hypertension after suboccipital decompression for Chiari malformation: case report. J Neurosurg 102:1147–1150CrossRef
17.
Zurück zum Zitat Parker EC, Teo C, Rahman S, Brodsky MC (2000) Complete resolution of hypertension after decompression of Chiari I malformation. Skull Base Surg 10:149–152CrossRef Parker EC, Teo C, Rahman S, Brodsky MC (2000) Complete resolution of hypertension after decompression of Chiari I malformation. Skull Base Surg 10:149–152CrossRef
18.
Zurück zum Zitat Patel SJ (2003) Electrical stimulation of the human ventro-lateral medulla for vasomotor mapping. Abstract presented at 2003 Annual Meeting of the Southern Neurosurgical Society, Orlando, Florida Patel SJ (2003) Electrical stimulation of the human ventro-lateral medulla for vasomotor mapping. Abstract presented at 2003 Annual Meeting of the Southern Neurosurgical Society, Orlando, Florida
19.
Zurück zum Zitat Ross CA, Ruggiero DA, Park DH, Joh TH, Sved AF, Fernandez-Pardal J, Saavedra JM, Reis DJ (1984) Tonic vasomotor control by the rostral ventrolateral medulla: effect of electrical or chemical stimulation of the area containing C1 adrenaline neurons on arterial pressure, heart rate, and plasma catecholamines and vasopressin. J Neurosci 4:474–494CrossRef Ross CA, Ruggiero DA, Park DH, Joh TH, Sved AF, Fernandez-Pardal J, Saavedra JM, Reis DJ (1984) Tonic vasomotor control by the rostral ventrolateral medulla: effect of electrical or chemical stimulation of the area containing C1 adrenaline neurons on arterial pressure, heart rate, and plasma catecholamines and vasopressin. J Neurosci 4:474–494CrossRef
20.
Zurück zum Zitat Sendeski MM, Consolim-Colombo FM, Leite CC, Rubira MC, Lessa P, Krieger EM (2006) Increased sympathetic nerve activity correlates with neurovascular compression at the rostral ventrolateral medulla. Hypertension 47:988–995CrossRef Sendeski MM, Consolim-Colombo FM, Leite CC, Rubira MC, Lessa P, Krieger EM (2006) Increased sympathetic nerve activity correlates with neurovascular compression at the rostral ventrolateral medulla. Hypertension 47:988–995CrossRef
21.
Zurück zum Zitat Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO (2011) Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging. J Neurosurg Pediatr 8:205–213CrossRef Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO (2011) Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging. J Neurosurg Pediatr 8:205–213CrossRef
22.
Zurück zum Zitat Tubbs RS, Wellons JC 3rd, Blount JP, Oakes WJ, Grabb PA (2004) Cessation of chronic hypertension after posterior fossa decompression in a child with Chiari I malformation: case report. J Neurosurg 100(2 Suppl Pediatrics):194–196PubMed Tubbs RS, Wellons JC 3rd, Blount JP, Oakes WJ, Grabb PA (2004) Cessation of chronic hypertension after posterior fossa decompression in a child with Chiari I malformation: case report. J Neurosurg 100(2 Suppl Pediatrics):194–196PubMed
23.
Zurück zum Zitat Zaffanello M, Sala F, Sacchetto L, Gasperi E, Piacentini G (2017) Evaluation of the central sleep apnea in asymptomatic children with Chiari 1 malformation: an open question. Childs Nerv Syst 33:829–832CrossRef Zaffanello M, Sala F, Sacchetto L, Gasperi E, Piacentini G (2017) Evaluation of the central sleep apnea in asymptomatic children with Chiari 1 malformation: an open question. Childs Nerv Syst 33:829–832CrossRef
Metadaten
Titel
Chiari I malformation with neurogenic hypertension after suboccipital decompression
verfasst von
Abdulelah A. Alluhaybi
Sarah Bin Abdulqader
Turki Alanazi
Khalid Altuhayni
Ayman Albanyan
Publikationsdatum
20.05.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 2/2021
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04670-y

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