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  • Title: Orthostatic hypotension associated with dorsal medullary cavernous angioma.
    Author: Idiaquez J, Araya P, Benarroch E.
    Journal: Acta Neurol Scand; 2009 Jan; 119(1):45-8. PubMed ID: 18549416.
    Abstract:
    BACKGROUND: Orthostatic hypotension (OH) is a rare manifestation of medulla oblongata lesions that may be because of interruption of descending sympathoexcitatory axons. AIMS: To illustrate the location of a medullary lesion that produced OH following resection in relationship to the location of putative sympathoexcitatory pathways. METHOD: A case with dorsal medullary cavernous angioma presenting with OH is described. The possible localization of lesion was compared with distribution of tyrosine hydroxylase (TH)-immunoreactive axons in a comparable section of the medulla of a control brain. RESULTS: The patient had marked OH after partial removal of the cavernous angioma. Biopsy confirmed the diagnosis. The magnetic resonance imaging location of the lesion overlapped that of TH-immunoreactive axons of the medullary transtegmental tract. CONCLUSIONS: A restricted lesion of medullary lesion interrupting the catecholaminergic transtegmental tract arising from the sympathoexcitatory C1 neurons of the rostral ventrolateral medulla could result in severe OH.
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