Endocrine Abstracts

Introduction: Neurogenic hypertension is associated with unilateral neurovascular compression of the brainstem and cranial nerves V, IX-X, VII, VIII. Causes may include nerve injury, vascular compression, tumors. Symptomatology seems hyperactive dysfunction syndrome of the cranial nerves. In the clinical picture, it can be seen trigeminal neuralgia, vertigo, tinnitus, hemifacial spasm, and in some cases hypertension.

Case report: Female patient, 45 years old, pianist, hospitalized in our department to investigate the etiology of hypertension. Symptoms began two years ago, while working at the computer, in the form of a sudden attack of vertigo, disorientation, anxious, with the simultaneous appearance of facial asymmetry (swollen left eyelid and down, left eyebrow and left corner of the mouth), and pain in the left side of the head, followed by high pressure 170/100 mmHg and tachycardia 120/min. The attack lasted about 20 min and passed spontaneously. Such attacks were two to three times a month and sometimes weekly. Between attacks she was healthy. The results of the functional and morphological studies show that the causes of the attacks are pathological changes in the pons. Examinations excluded renovascular and endocrine causes of hypertension. Magnetic resonance imaging of the head found a malformation of blood vessels in the border edge infratentorially midbrain and pons. Electroencephalogram was normal several times.

Conclusion: Neurogenic hypertension was the result of vascular compression of the cranial nerves and brainstem and treatment with Bisoprolol and Tegretol led to a reduction in the frequency of attacks.