Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Hypertensive Encephalopathy with Reversible Brainstem Edema

  • Lee, Sungjoon (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Cho, Byung-Kyu (Department of Neurosurgery, The Armed Forces Capital Hospital) ;
  • Kim, Hoon (Department of Neurosurgery, The Catholic University of Korea, Bucheon St. Mary's Hospital)
  • Received : 2013.03.23
  • Accepted : 2013.08.05
  • Published : 2013.08.28
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Abstract

Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury.

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References

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