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The 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.

Original publication

DOI

10.2349/biij.3.1.e14

Type

Journal article

Journal

Biomed Imaging Interv J

Publication Date

01/2007

Volume

3

Keywords

Autonomic, deep brain stimulation, microvascular decompression, neurosurgery, periaqueductal grey, rostral ventrolateral medulla