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http://dx.doi.org/10.3340/jkns.2013.54.2.139

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)
Publication Information
Journal of Korean Neurosurgical Society / v.54, no.2, 2013 , pp. 139-141 More about this Journal
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.
Keywords
Brain stem; Edema; Encephalopathy; Hypertension;
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