Replicating brainstem symptoms by head down tilting in hypertensive patients with brainstem infarction
Stoica, E.; Voiculescu, V.
Neurologie et Psychiatrie 22(2): 129-136
1984
ISSN/ISBN: 0259-6326 PMID: 6463545 Document Number: 227078
During head down (HD) tilting (4.degree.), 26 (37%) of 70 hypertensive patients with brainstem infarction developed neurological symptoms which suggest the prevalent involvement of the brainstem area. The most common manifestations produced by the maneuvre were: diplopia, vertigo, paresthesia, nausea, respiratory disorders, narrowing of visual field. The neurological disorders induced by HD tilting are due to cerebral venostasis; such patients are unable to deactivate their sympathetic nervous system (SNS) during tilting and then to augment their peripheral blood volume; the result will be an increase in thoracopulmonary blood volume which hampers the cerebral venous draining. The brainstem neurological disorders observed in some hypertensives with and without cerebrovascular accidents after a prolonged recumbency might be related in terms of pathogeny with the neurological disorders induced by HD tilting.