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Hypertensive encephalopathy: complication in children treated for myeloproliferative disorders--report of three cases

M J Cooney1, W G Bradley, S C Symko

  • 1Department of Radiology, Long Beach Memorial Medical Center, CA 90806, USA.

Radiology
|March 14, 2000
PubMed

Insights

Diffusion-weighted imaging can help differentiate seizures from hypertensive encephalopathy in children with acute leukemia. Normal diffusion-weighted images suggest hypertensive encephalopathy, allowing for prompt treatment and reversal of symptoms.

Area of Science:

  • Neurology
  • Pediatric Oncology
  • Radiology

Background:

  • Routine brain magnetic resonance (MR) imaging with echo-planar diffusion-weighted sequences is standard for patients undergoing chemotherapy.
  • Children with acute leukemia undergoing chemotherapy can present with neurological symptoms like seizures.

Observation:

  • Three pediatric patients with acute leukemia presented with seizures.
  • Conventional MR imaging revealed apparent acute, posterior, parasagittal infarcts.
  • However, diffusion-weighted imaging (DWI) sequences showed normal results.

Findings:

  • The MR imaging findings, particularly the normal DWI, were inconsistent with infarcts.
  • The pattern suggested hypertensive encephalopathy, a condition associated with chemotherapy.

Implications:

  • Early recognition of minimal hypertension is crucial in pediatric oncology patients.
  • Prompt treatment of hypertensive encephalopathy can lead to reversal of neurological symptoms.
  • Diffusion-weighted imaging plays a key role in differentiating stroke mimics from actual ischemic events in this population.

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