Brainstem: Difference between revisions
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There are anecdotal accounts of all ME/CFS symptoms, including [[Postural orthostatic tachycardia syndrome|POTS]] and fatigue, going away after a craniocervical fusion to correct the brainstem compression.<ref>{{Cite news|url=https://forums.phoenixrising.me/index.php?threads/have-you-ruled-out-chiari-as-a-cause-of-your-cfs.56908/#post-945253|title=Have you ruled out Chiari as a cause of your CFS|work=Phoenix Rising ME / CFS Forums|access-date=2018-10-26|language=en-US}}</ref> | There are anecdotal accounts of all ME/CFS symptoms, including [[Postural orthostatic tachycardia syndrome|POTS]] and fatigue, going away after a craniocervical fusion to correct the brainstem compression.<ref>{{Cite news|url=https://forums.phoenixrising.me/index.php?threads/have-you-ruled-out-chiari-as-a-cause-of-your-cfs.56908/#post-945253|title=Have you ruled out Chiari as a cause of your CFS|work=Phoenix Rising ME / CFS Forums|access-date=2018-10-26|language=en-US}}</ref> | ||
As the brainstem is central to regulating the autonomic nervous system, it is perhaps unsurprising that dysautonomia (such as POTS) can be | As the brainstem is central to regulating the [[autonomic nervous system]],<ref>{{Cite journal|last=Martín-Gallego|first=A.|last2=González-García|first2=L.|last3=Carrasco-Brenes|first3=A.|last4=Segura-Fernández-Nogueras|first4=M.|last5=Delgado-Babiano|first5=A.|last6=Ros-Sanjuán|first6=A.|last7=Romero-Moreno|first7=L.|last8=Domínguez-Páez|first8=M.|last9=Dawid-Milner|first9=M. S.|date=2017|title=Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View|url=https://www.ncbi.nlm.nih.gov/pubmed/28120078|journal=Acta Neurochirurgica. Supplement|volume=124|pages=221–229|doi=10.1007/978-3-319-39546-3_34|issn=0065-1419|pmid=28120078}}</ref> it is perhaps unsurprising that dysautonomia (such as POTS) can be alleviated by correcting brainstem compression. | ||
==Diagnosis== | ==Diagnosis== | ||
Brainstem compression is diagnosed via dynamic imaging, such as flexion-extension MRIs and rotational CT scans. The most common measurements used to diagnose and quantify brainstem compression are the Clivo-Axial Angle, the Grabb-Oakes Measurement, and the Basion-Dens Interval.<ref name=":1" /> | Brainstem compression is diagnosed via dynamic imaging, such as flexion-extension MRIs and rotational CT scans. The most common measurements used to diagnose and quantify brainstem compression are the Clivo-Axial Angle, the Grabb-Oakes Measurement, and the Basion-Dens Interval.<ref name=":1" /> |
Revision as of 23:37, October 26, 2018
Brainstem Compression often occurs as a result of craniocervical instability (CCI).[1][2]
Evidence[edit | edit source]
Recent peer-reviewed research indicates that mechanical brainstem compression can be directly responsible for dysautonomia and fatigue.[1][2] When patients had a fusion surgery to correct their brainstem compression, their symptoms of brainstem compression significantly improved or resolved completely.[2]
There are anecdotal accounts of all ME/CFS symptoms, including POTS and fatigue, going away after a craniocervical fusion to correct the brainstem compression.[3]
As the brainstem is central to regulating the autonomic nervous system,[4] it is perhaps unsurprising that dysautonomia (such as POTS) can be alleviated by correcting brainstem compression.
Diagnosis[edit | edit source]
Brainstem compression is diagnosed via dynamic imaging, such as flexion-extension MRIs and rotational CT scans. The most common measurements used to diagnose and quantify brainstem compression are the Clivo-Axial Angle, the Grabb-Oakes Measurement, and the Basion-Dens Interval.[2]
Treatment[edit | edit source]
A cervical collar can be tried to see if it helps alleviate the neurological symptoms (even if only partially). However, a cervical collar is not an actual treatment for CCI. The standard treatment to correct brainstem compression is a craniocervical fusion surgery,[2] performed by a CCI-literate neurosurgeon.
See also[edit | edit source]
- Craniocervical instability
- Cervical stenosis
- Autonomic control of energy metabolism
References[edit | edit source]
- ↑ 1.0 1.1 Henderson, Fraser C.; Henderson, Fraser C.; Wilson, William A.; Mark, Alexander S.; Koby, Myles (March 3, 2017). "Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review". Neurosurgical Review. 41 (1): 149–163. doi:10.1007/s10143-017-0830-3. ISSN 0344-5607. PMC 5748419. PMID 28258417.
- ↑ 2.0 2.1 2.2 2.3 2.4 Henderson, Fraser C.; Wilson, William A.; Mott, Stephen; Mark, Alexander; Schmidt, Kristi; Berry, Joel K.; Vaccaro, Alexander; Benzel, Edward (July 16, 2010). "Deformative stress associated with an abnormal clivo-axial angle: A finite element analysis". Surgical Neurology International. 1. doi:10.4103/2152-7806.66461. ISSN 2152-7806. PMC 2940090. PMID 20847911.
- ↑ "Have you ruled out Chiari as a cause of your CFS". Phoenix Rising ME / CFS Forums. Retrieved October 26, 2018.
- ↑ Martín-Gallego, A.; González-García, L.; Carrasco-Brenes, A.; Segura-Fernández-Nogueras, M.; Delgado-Babiano, A.; Ros-Sanjuán, A.; Romero-Moreno, L.; Domínguez-Páez, M.; Dawid-Milner, M. S. (2017). "Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View". Acta Neurochirurgica. Supplement. 124: 221–229. doi:10.1007/978-3-319-39546-3_34. ISSN 0065-1419. PMID 28120078.