[Surgical treatment of essential hypertension resistant to medical treatment: Report of two cases].

OBJECTIVE

To demonstrate that microvascular decompression of the left medulla oblongata is a safe and effective treatment modality in the treatment of "essential" hypertension.

METHODS

Two patients with medically refractory hypertension underwent microvascular decompression of the left rostral ventrolateral medulla oblongata. Causes such as renal diseases, carcinoid syndrome, pheochromocytoma were ruled out before surgery. Indications for surgery included mainly systolic blood pressures greater than 180 mm Hg or uncontrolled blood pressures under three or more medications.

RESULTS

Both patients experienced more than 20 mm Hg reduction in systolic blood pressure although the number of medications was decreased after surgery.

CONCLUSION

Microvascular decompression of the left rostral ventrolateral medulla oblongata may be an effective modality in the treatment of "essential" hypertension.