{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T06:30:33Z","timestamp":1774506633694,"version":"3.50.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2000,8]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Paroxysmal neurogenic hypertension has been associated with a variety of diseases affecting the brain stem but has only rarely been reported after brain stem stroke. The mechanism is thought to involve increased sympathetic activity and baroreflex dysfunction. We undertook microneurographic recordings of muscle sympathetic nerve activity (MNSA) during beat-to-beat blood pressure (BP) monitoring to investigate this hypothesis.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Case Description<\/jats:italic>\n            \u2014We investigated a 75-year-old woman who developed paroxysmal hypertension (BP 220\/110 mm Hg) after a large left-sided medullary infarct. The paroxysms were triggered by changes in posture and were accompanied by tachycardia, diaphoresis, and headache. Serum catecholamines were substantially increased (norepinephrine level, 23.9 nmol\/L 9 days after stroke; normal level, &lt;3.8 nmol\/L), and heart rate variability, measured by spectral analysis, was decreased in both low- and high-frequency domains (0.04 and 0.06 ms\n            <jats:sup>2<\/jats:sup>\n            , respectively; normal level, 0.14\u00b10.02 ms\n            <jats:sup>2<\/jats:sup>\n            ). MNSA was increased in frequency (61 bursts per minute; normal level, 34\u00b118 bursts per minute), and the burst amplitude was not inversely related to diastolic BP. BP and MNSA responses to cold pressor and isometric handgrip stimuli were intact.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Extensive unilateral infarction of the brain stem in the region of the nucleus tractus solitarius may result in partial baroreflex dysfunction, increased sympathetic activity, and neurogenic paroxysmal hypertension.\n          <\/jats:p>","DOI":"10.1161\/01.str.31.8.1997","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:10:52Z","timestamp":1308341452000},"page":"1997-2001","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Brain Stem Stroke Causing Baroreflex Failure and Paroxysmal Hypertension"],"prefix":"10.1161","volume":"31","author":[{"given":"A. M.","family":"Phillips","sequence":"first","affiliation":[{"name":"From the Departments of General Medicine (A.M.P., D.L.J.), Neurology (P.J.P.), Radiology (T.H.), and Cardiology (H.I.), Christchurch Hospital (New Zealand)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. L.","family":"Jardine","sequence":"additional","affiliation":[{"name":"From the Departments of General Medicine (A.M.P., D.L.J.), Neurology (P.J.P.), Radiology (T.H.), and Cardiology (H.I.), Christchurch Hospital (New Zealand)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. J.","family":"Parkin","sequence":"additional","affiliation":[{"name":"From the Departments of General Medicine (A.M.P., D.L.J.), Neurology (P.J.P.), Radiology (T.H.), and Cardiology (H.I.), Christchurch Hospital (New Zealand)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Hughes","sequence":"additional","affiliation":[{"name":"From the Departments of General Medicine (A.M.P., D.L.J.), Neurology (P.J.P.), Radiology (T.H.), and Cardiology (H.I.), Christchurch Hospital (New Zealand)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Ikram","sequence":"additional","affiliation":[{"name":"From the Departments of General Medicine (A.M.P., D.L.J.), Neurology (P.J.P.), Radiology (T.H.), and Cardiology (H.I.), Christchurch Hospital (New Zealand)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1961.03620100051007"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.9.8073450"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.7.1401"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1990.tb00287.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.9.1671"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/96.2.277"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000108194"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/32.11.2030"},{"key":"e_1_3_2_9_2","first-page":"399","volume":"83","year":"1976","unstructured":"Sadler WA, Lynskey CP, Gilchrist NL, Espiner EA, Nicholls MG. A sensitive radioimmunoassay for measuring plasma anti-diuretic hormone in man. NZ Med J. 1976;83:399\u2013401.","journal-title":"NZ Med J"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1979.59.4.919"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.93.5.1043"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","unstructured":"Jardine DL Ikram H Frampton CM Frethey R Bennett SI Crozier IG. Autonomic control of vasovagal syncope. Am J Physiol. 1998;274(Heart Circ Physiol 43):H2110\u2013H2115.","DOI":"10.1152\/ajpheart.1998.274.6.H2110"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1978.sp012170"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/108.2.423"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/106.3.589"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)62272-1"},{"key":"e_1_3_2_17_2","unstructured":"Reis DJ. The brain and hypertension: reflections on 35 years of inquiry into the neurobiology of the circulation. Circulation. 1984;70(suppl III):S31\u2013S45."},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","unstructured":"Eckberg DL Sleight P. Human Baroreflexes in Health and Disease. New York NY: Oxford University Press; 1992:251\u2013254.","DOI":"10.1093\/oso\/9780198576938.001.0001"},{"key":"e_1_3_2_19_2","first-page":"130","volume":"69","year":"1988","unstructured":"Gandhavadi B. Hypertension after brainstem stroke. Arch Phys Med Rehabil. 1988;69:130\u2013131.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.57.5.487"},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","unstructured":"Magnus O Koster M Van der Drift JHA. Cerebral mechanisms and neurogenic hypertension in man with special reference to baroreceptor control. In: De Jong W Provoost AP Shapiro AP eds. Hypertension and Brain Mechanisms. Vol 47 of Progress in Brain Research. Amsterdam Netherlands: Elsevier North-Holland Biomedical Press; 1977:199\u2013218.","DOI":"10.1016\/S0079-6123(08)62726-0"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/hyp.30.5.1072"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-351X(05)80186-7"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199311113292011"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199311113292003"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1994.74.2.323"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.31.8.1997","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:20:20Z","timestamp":1715552420000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.31.8.1997"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,8]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2000,8]]}},"alternative-id":["10.1161\/01.STR.31.8.1997"],"URL":"https:\/\/doi.org\/10.1161\/01.str.31.8.1997","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,8]]},"assertion":[{"value":"2000-01-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-05-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}