Neurogenic orthostatic hypotension and afferent baroreflex failure secondary to brainstem lesions

We conducted a retrospective chart review of three patients with brainstem lesions, reporting their clinical features, autonomic function data, and high-resolution brain imaging to identify the site of the lesion in relation to the Nucleus of the Solitary Tract (NST). The first patient experienced neurogenic orthostatic hypotension (NOH) following a brainstem tumor resection with unilateral damage to the NST. The second patient had a giant vascular tumor compressing the brainstem, presenting as afferent baroreflex failure (ABRF). The third patient had a brainstem infiltrating and expanding tumor, exhibiting both presentations: NOH and ABRF. The patient's characteristics, clinical course, and treatment were discussed, along with a review of the literature.