Article Text
Summary
A 47-year-old man with poorly controlled hypertension presented with headaches, right-sided weakness and dysarthria. CT and MRI scans of the brain showed widespread abnormalities including significant pontine oedema, basal ganglia and corona radiata infarctions and cerebellar white matter high signal. Imaging of the intracerebral vasculature also demonstrated wall irregularities. Initially a central nervous system inflammatory disorder was thought to be the most likely diagnosis, possibly acute demyelinating encephalomyelitis or cerebral vasculitis, and the patient was treated with high-dose intravenous steroids. The diagnosis of hypertensive encephalopathy was made because (1) the patient was hypertensive and (2) the patients MRI findings resolved with antihypertensive treatment.
Blood pressure treatment was instigated from admission, and the patients symptoms improved with resolution of the radiological abnormalities.
- brain stem / cerebellum
- neuroimaging
- hypertension
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Footnotes
Contributors DC lead author: case selection, data collection, literature review, case writing, images selection. DH: proof reading. IB: proof reading. TW: main co-author and supervisor, draft correction and proof reading, main advisor.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.