Korean J Stroke.  2012 Dec;14(3):166-169.

Hypertensive Brainstem Encephalopathy with Atypical Supratentorial Involvement

• Lee JG
• Roh H
• Jang IM
• Lee KB
• Ahn MY

Abstract

Hypertensive brainstem encephalopathy (HBE) is a variant of hypertensive encephalopathy characterized by brainstem and cerebellar involvement. Simultaneous supratentorial involvement in HBE is rarely reported as a vasogenic edema in subcortex and/or periventricular white matter. A 36-year-old woman visited hospital due to headache lasting 7 days before admission. Initial blood pressure was 270/170mmHg. T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging revealed multifocal high signal intensity lesions in upper medulla, pons, midbrain and cerebellar hemisphere. Especially, atypical periventricular lesions were shown as perpendicular fingers to the lateral ventricle like multiple sclerosis. Her clinical symptoms and radiological lesions were subsided with lowering blood pressure. We herein report a HBE with unusual supratentorial involvement mimicking multiple sclerosis.

Keyword

Hypertensive encephalopathy; Multiple sclerosis; Reversible posterior leukoencephalopathy syndrome

MeSH Terms

Blood Pressure
Brain Stem
Edema
Female
Fingers
Headache
Humans
Hypertensive Encephalopathy
Lateral Ventricles
Magnetic Resonance Imaging
Mesencephalon
Multiple Sclerosis
Pons
Posterior Leukoencephalopathy Syndrome