{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:55:03Z","timestamp":1771062903375,"version":"3.50.1"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"25","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,21]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Blood pressure (BP) dysregulation is frequently observed in patients after surgical management of brainstem lesions; however, there has been no standard rehabilitation. Considering the conflicting risks for hypoperfusion and disuse syndrome in these patients, a safe and effective rehabilitative strategy is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 50-year-old man who had undergone craniotomy for resection of a recurrent dorsal medullary epidermoid cyst developed persistent orthostatic hypotension. It was resistant to physical exercise, pharmacological therapy, abdominal binders, and compression stockings; therefore, it inhibited postoperative rehabilitation. Although the responsible lesion was not clearly visible on the postoperative image, accompanying symptoms, including segmental sensory impairment, implied an improvement in BP control. Although there was a trade-off between the risk of developing disuse syndrome and a delay in functional recovery, the authors decided to continue a conservative rehabilitation strategy rather than increasing the workload. The patient\u2019s BP control was gradually restored by the seventh postoperative week, and the authors proceeded with basic activity training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>A conservative prognostic prediction-based rehabilitation strategy was applied in this case. The precise evaluation of the accompanying neurological symptoms was helpful in deciding the treatment regimen. The conflicting risks for hypoperfusion and disuse syndrome in such cases must be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case2136","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T03:02:45Z","timestamp":1624244565000},"source":"Crossref","is-referenced-by-count":1,"title":["Conservative rehabilitation for a patient presenting with severe orthostatic hypotension after surgical management of brainstem tumor: illustrative case"],"prefix":"10.3171","volume":"1","author":[{"given":"Misato","family":"Nagumo","sequence":"first","affiliation":[{"name":"Departments of Rehabilitation Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syoichi","family":"Tashiro","sequence":"additional","affiliation":[{"name":"Departments of Rehabilitation Medicine and"},{"name":"Neurosurgery, Keio University School of Medicine, Tokyo, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanako","family":"Hijikata","sequence":"additional","affiliation":[{"name":"Departments of Rehabilitation Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiko","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Departments of Rehabilitation Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takenori","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Departments of Rehabilitation Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Comp Neurol","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1002\/cne.902730207","article-title":"Catecholaminergic neurons in the ventrolateral medulla and nucleus of the solitary tract in the human","volume":"273","author":"Arango V","year":"1988","unstructured":"Arango V, Ruggiero DA, Callaway JL,  Catecholaminergic neurons in the ventrolateral medulla and nucleus of the solitary tract in the human. 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