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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:803-806, May 2004
© 2004 American Society of Neuroradiology

Case Report
BRAIN

Brain Stem Hypertensive Encephalopathy Evaluated by Line Scan Diffusion-Weighted Imaging

Motonori Nagata^a, Masayuki Maeda^a,b,c, Hirokazu Tsukahara^b, Stephan E. Maier^c and Ken Takeda^a

^a Department of Radiology, Mie University School of Medicine, Tsu, Mie, Japan
^b Department of Pediatrics, Fukui Medical University, Matsuoka, Fukui, Japan
^c Department of Radiology, Brigham & Women’s Hospital, Boston, MA

Address correspondence to Masayuki Maeda, MD, Mie University School of Medicine, Department of Radiology, 2–174 Edobashi, Tsu, Mie 514-8507, Japan

Summary: Hypertensive encephalopathy rarely presents with predominant involvement of the brain stem and relative sparing of the supratentorial regions. We describe the MR imaging features in a patient with reversible brain stem hypertensive encephalopathy. Extensive hyperintensity was predominantly seen in brain stem regions on fluid-attenuated inversion-recovery and T2-weighted images. These lesions showed an increased apparent diffusion coefficient with the use of line scan diffusion-weighted imaging. The clinical findings and MR imaging abnormalities resolved with control of hypertension.