{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T18:58:11Z","timestamp":1785869891458,"version":"3.56.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Several studies have suggested that neurovascular compression (NVC) of the brainstem might be a cause of hypertension. Because this compression syndrome might be demonstrated by MR imaging studies, several authors have tried to assess its prevalence in small series of patients with hypertension. This article presents a meta-analysis of these studies.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The studies reviewed by the authors were based on MR imaging and included the presence of left-sided NVC of the left rostral ventrolateral medulla oblongata (RVLM) and\/or the cranial nerves IX and X root entry zone in patients with apparent primary hypertension compared with normotensive patients. Several studies also included patients with secondary hypertension as an additional control group, which is analyzed separately.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Meta-analysis included data from 14 studies (597 patients with primary hypertension and 609 controls). The effect size was OR 2.68 (95% CI 1.51\u20134.75, p = 0.001) (random effect), which is consistent with the hypothesis that NVC of the left RVLM is more frequent in patients with apparent primary hypertension compared with normotensive individuals. Stratification for the study design revealed an effect size for prospective studies of OR 1.97 (95% CI 0.74\u20135.30, p = 0.178) and for retrospective studies of OR 3.36 (95% CI 1.66\u20136.79, p = 0.001).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This meta-analysis indicates a statistically significant effect size for left-sided NVC in apparent primary hypertension. However, this effect is absent if subanalysis is confined to prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.7.jns101378","type":"journal-article","created":{"date-parts":[[2011,9,16]],"date-time":"2011-09-16T14:41:58Z","timestamp":1316184118000},"page":"147-156","source":"Crossref","is-referenced-by-count":24,"title":["Primary hypertension and neurovascular compression: a meta-analysis of magnetic resonance imaging studies"],"prefix":"10.3171","volume":"116","author":[{"given":"Hieronymus D.","family":"Boogaarts","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Menovsky","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"de Vries","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 L. M.","family":"Verbeek","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques W.","family":"Lenders","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Andr\u00e9","family":"Grotenhuis","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101378","series-title":"AJNR Am J Neuroradiol","first-page":"401","article-title":"Essential hypertension and neurovascular compression at the ventrolateral medulla oblongata: MR evaluation","volume":"16","author":"Akimura","year":"1995"},{"key":"b2-jns101378","series-title":"J Hum Hypertens","first-page":"179","article-title":"Neurovascular compression in essential hypertension: cause, consequence or unrelated finding?","volume":"21","author":"Ceral","year":"2007"},{"key":"b3-jns101378","series-title":"J Hypertens","first-page":"2027","article-title":"Arterial compression of the retro-olivary sulcus of the medulla in essential hypertension: a multivariate analysis","volume":"23","author":"Coffee","year":"2005"},{"key":"b4-jns101378","series-title":"J Neurosurg","first-page":"226","article-title":"Magnetic resonance evaluation of ventrolateral medullary compression in essential hypertension","volume":"88","author":"Col\u00f3n","year":"1998"},{"key":"b5-jns101378","series-title":"Lancet","first-page":"446","article-title":"Decrease of blood pressure by ventrolateral medullary decompression in essential hypertension","volume":"352","author":"Geiger","year":"1998"},{"key":"b6-jns101378","series-title":"Riv Neurobiol","first-page":"295","article-title":"Ipertensione arteriosa e compressione vascolare sul bulbo","volume":"44","author":"Giuffrida","year":"1998"},{"key":"b7-jns101378","series-title":"Hypertension","first-page":"176","article-title":"Neurovascular contact of cranial nerve IX and X root-entry zone in hypertensive patients","volume":"37","author":"Hohenbleicher","year":"2001"},{"key":"b8-jns101378","series-title":"Neurosurgery","first-page":"165","article-title":"Neurovascular compression associated with essential hypertension, in Joint Meeting of the Neurosurgical Society of American and the Mexican Society of Neurological Surgery, Acapulco, Mexico, January 22 to 26, 1978. Abstracts","volume":"2","author":"Jannetta","year":"1978"},{"key":"b9-jns101378","series-title":"Ann Surg","first-page":"391","article-title":"Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients","volume":"201","author":"Jannetta","year":"1985"},{"key":"b10-jns101378","series-title":"Ann Surg","first-page":"253","article-title":"Neurogenic hypertension: etiology and surgical treatment. II. Observations in an experimental nonhuman primate model","volume":"202","author":"Jannetta","year":"1985"},{"key":"b11-jns101378","series-title":"Neuroradiology","first-page":"99","article-title":"The role of MRI in screening for neurogenic hypertension","volume":"42","author":"Johnson","year":"2000"},{"key":"b12-jns101378","series-title":"Neurosurgery","first-page":"1","article-title":"Microvascular decompression of the left lateral medulla oblongata for severe refractory neurogenic hypertension","volume":"43","author":"Levy","year":"1998"},{"key":"b13-jns101378","series-title":"Surg Neurol","first-page":"2","article-title":"Microvascular decompression in the treatment of hypertension: review and update","volume":"55","author":"Levy","year":"2001"},{"key":"b14-jns101378","series-title":"Summing Up: The Science of Reviewing Research","author":"Light","year":"1984"},{"key":"b15-jns101378","series-title":"Hypertension","first-page":"77","article-title":"Neurovascular compression of the rostral ventrolateral medulla related to essential hypertension","volume":"30","author":"Morimoto","year":"1997"},{"key":"b16-jns101378","series-title":"J Hum Hypertens","first-page":"807","article-title":"The potent role of increased sympathetic tone in pathogenesis of essential hypertension with neurovascular compression","volume":"14","author":"Morise","year":"2000"},{"key":"b17-jns101378","series-title":"Lancet","first-page":"1466","article-title":"Posterior fossa neurovascular anomalies in essential hypertension","volume":"344","author":"Naraghi","year":"1994"},{"key":"b18-jns101378","series-title":"J Neurosurg","first-page":"1006","article-title":"Investigations using magnetic resonance imaging: is neurovascular compression present in patients with essential hypertension?","volume":"96","author":"S\u00e4glitz","year":"2002"},{"key":"b19-jns101378","series-title":"Invest Radiol","first-page":"774","article-title":"Neurogenic hypertension. A new MRI protocol for the evaluation of neurovascular compression of the cranial nerves IX and X root-entry zone","volume":"34","author":"Schmitz","year":"1999"},{"key":"b20-jns101378","series-title":"Neuroradiology","first-page":"21","article-title":"The spectrum of magnetic resonance imaging findings in hypertension-related neurovascular compression","volume":"48","author":"Sendeski","year":"2006"},{"key":"b21-jns101378","series-title":"J Am Coll Cardiol","first-page":"1453","article-title":"Relationship of neurovascular compression to central sympathetic discharge and essential hypertension","volume":"43","author":"Smith","year":"2004"},{"key":"b22-jns101378","series-title":"JAMA","first-page":"2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. 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