Hypertensive Encephalopathy Extending into the Whole Brainstem and Deep Structures

Yasuhiro KUMAI; Kazunori TOYODA; Kenichiro FUJII; Setsuro IBAYASHI

doi:10.1291/hypres.25.797

Case Report

Hypertensive Encephalopathy Extending into the Whole Brainstem and Deep Structures

Yasuhiro KUMAI, Kazunori TOYODA, Kenichiro FUJII, Setsuro IBAYASHI

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Keywords: hypertensive encephalopathy, malignant hypertension, brainstem, magnetic resonance imaging, cerebral autoregulation

JOURNAL FREE ACCESS

2002 Volume 25 Issue 5 Pages 797-800

DOI https://doi.org/10.1291/hypres.25.797

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Abstract

In patients with hypertensive encephalopathy, brain edema is frequently distributed in the parieto-occipital white matter. We report a patient with high arterial blood pressure of over 300/160 mmHg on admission, who had extensive MRI-documented reversible lesions throughout the whole brain, including the brainstem, thalami, basal ganglia, and cerebellum. Extraordinarily severe acceleration of hypertension may be essential for the breakdown of autoregulation in the deep structures, especially in the brainstem including medulla. (Hypertens Res 2002; 25: 797-800)

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