J Clin Neurol.  2007 Mar;3(1):50-52. 10.3988/jcn.2007.3.1.50.

Two Cases of Hypertensive Encephalopathy Involving the Brainstem

• Kang SY
• Choi JC
• Kang JH

• KMID: 1700687
• DOI: http://doi.org/10.3988/jcn.2007.3.1.50

Abstract

Hypertensive encephalopathy is a medical emergency whose clinical manifestations are usually associated with bilateral parieto-occipital lesions. Predominant brainstem edema without accompanying occipital lesions is rare in hypertensive encephalopathy and usually occurs in patients with secondary hypertension. We describe the clinical and radiological features of two patients with reversible hypertensive brainstem encephalopathy. Both patients had chronic renal failure, but the extensive neuroimaging abnormalities revealed few clinical features of brainstem involvement. The clinical findings and neuroimaging abnormalities resolved once the hypertension was treated.

Keyword

Hypertension; Brainstem; Hypertensive encephalopathy

MeSH Terms

Brain Stem*
Edema
Emergencies
Humans
Hypertension
Hypertensive Encephalopathy*
Kidney Failure, Chronic
Neuroimaging

Figure

• 

  Figure 1 MRI images of case 1. Initial axial T2-weighted images (A, B). Normal intensity in the diffusion-weighted image and signals of increased intensity in the apparent diffusion coefficient mapping are present in the region of the high-intensity signal in the T2-weighted image (C, D). T2-weighted image at follow-up evaluation (E, F). Note the relative sparing of the posterior supratentorial regions (B).

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