Hypertensive brainstem encephalopathy without parieto-occipital lesion--two case reports.

Two patients presented with malignant hypertension associated with encephalopathy predominantly manifesting as brainstem lesion. T(2)-weighted and fluid-attenuated inversion recovery magnetic resonance (MR) imaging revealed diffuse hyperintense areas in the pons and scattered lesions in the cerebellum, basal ganglia, and cerebral subcortex without parieto-occipital lesions. Diffusion-weighted MR imaging demonstrated these lesions as normal intensity, indicating vasogenic edema. These lesions resolved rapidly once hypertension was controlled. Review of clinical findings for 14 other patients with hypertensive brainstem encephalopathy without parieto-occipital lesions suggested that anterior circulation structures supplied by the carotid artery are frequently involved in such patients.

[1]  I. Akiguchi,et al.  Hypertensive brainstem encephalopathy. , 2003, Internal medicine.

[2]  N. Newman,et al.  Hypertensive brainstem encephalopathy: clinical and radiographic features , 2003, Journal of the Neurological Sciences.

[3]  N. Campeau,et al.  Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images. , 2002, AJNR. American journal of neuroradiology.

[4]  K. Chu,et al.  Diffusion-Weighted MR Findings in Brain Stem Hypertensive Encephalopathy: A Possibility of Cytotoxic Edema? , 2001, European Neurology.

[5]  F. Morello,et al.  Hypertensive brain stem encephalopathy: clinically silent massive edema of the pons , 2001, Neurological Sciences.

[6]  C. Truwit,et al.  Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. , 2000, AJNR. American journal of neuroradiology.

[7]  A. Destée,et al.  Unusual MR findings of the brain stem in arterial hypertension. , 2000, AJNR. American journal of neuroradiology.

[8]  J. Keane,et al.  Hypertensive brainstem encephalopathy: Three cases presenting with severe brainstem edema , 1999, Neurology.

[9]  D. Rosenbaum,et al.  Ptosis, blepharospasm, and apraxia of eyelid opening secondary to putaminal hemorrhage , 1999, Neurology.

[10]  E. Lis,et al.  Posterior leukoencephalopathy syndrome may not be reversible. , 1999, Pediatric neurology.

[11]  L H Schwamm,et al.  Diffusion-weighted imaging discriminates between cytotoxic and vasogenic edema in a patient with eclampsia. , 1997, Stroke.

[12]  M. Miyaoka,et al.  Malignant hypertension associated with obstructive hydrocephalus--case report. , 1997, Neurologia medico-chirurgica.

[13]  L R Caplan,et al.  A reversible posterior leukoencephalopathy syndrome. , 1996, The New England journal of medicine.

[14]  I. Shirouzu,et al.  Hypertensive encephalopathy: reversible CT and MR appearance. , 1993, Radiation medicine.

[15]  R. Schwartz,et al.  Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. , 1992, AJR. American journal of roentgenology.

[16]  K. Takeda,et al.  Central pontine myelinolysis diagnosed by magnetic resonance imaging , 1985, Annals of neurology.

[17]  A. Egol,et al.  Hypertensive encephalopathy. , 1983, Stroke.

[18]  A. Bill,et al.  Cerebral circulation in acute arterial hypertension--protective effects of sympathetic nervous activity. , 1981, Acta physiologica Scandinavica.

[19]  W. Rosenblum.  Letter: Hypertensive encephalopathy. , 1974 .