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Is reversible posterior leukoencephalopathy with severe hypertension completely reversible in all patients?

Narayan Prasad1, Sanjeev Gulati, Rakesh Kumar Gupta

  • 1Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Pediatric Nephrology (Berlin, Germany)
|September 25, 2003
PubMed

Insights

Severe hypertension in children can cause leukoencephalopathy, a reversible brain condition. Prompt hypertension control leads to clinical and radiological recovery in most pediatric cases.

Area of Science:

  • Pediatric Nephrology
  • Neurology
  • Radiology

Background:

  • Leukoencephalopathy with severe hypertension is a rare pediatric condition.
  • Few case reports exist, necessitating further clinical evaluation.
  • Understanding its features, severity, and prognosis is crucial.

Purpose of the Study:

  • To prospectively evaluate clinical features, severity, reversibility, and prognosis of leukoencephalopathy in children with severe hypertension.
  • To characterize neuroimaging findings using MRI and MRA.
  • To assess outcomes after hypertension management.

Main Methods:

  • Prospective study of 18 children with severe hypertension.
  • Clinical assessment, biochemical tests, MRI, and MRA.
  • Follow-up evaluation of clinical and radiological findings.

Main Results:

  • Headache, confusion, drowsiness, nausea, vomiting, and visual disturbances were common symptoms.
  • MRI revealed leukoencephalopathic changes in 16/18 patients; MRA showed cerebral artery attenuation in 11/18.
  • Most MRI findings resolved, and MRA normalized after hypertension control, with some exceptions.

Conclusions:

  • Leukoencephalopathy in children with severe hypertension is largely reversible with controlled blood pressure.
  • Most patients experience clinical and radiological improvement.
  • A minority may have residual damage, requiring neurodevelopmental follow-up.

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