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Hypertension-induced cerebellar encephalopathy and hydrocephalus in a male

Kuang-Lin Lin1, Wen-Chin Hsu, Huei-Shyong Wang

  • 1Division of Pediatric Neurology, Chang Gung Children's Hospital, Chang Gung University Medical College, Taoyuan, Taiwan.

Pediatric Neurology
|December 27, 2005
PubMed

Insights

Hypertensive encephalopathy, a rare condition in children, can cause severe neurological issues due to sudden high blood pressure. Prompt treatment can reverse associated cerebellar lesions and hydrocephalus, preventing misdiagnosis as a tumor.

Area of Science:

  • Neurology
  • Pediatrics
  • Nephrology

Background:

  • Hypertensive encephalopathy (HE) is a neurological emergency caused by a rapid increase in systemic blood pressure.
  • It is uncommon in pediatric populations and can lead to severe, irreversible neurological damage if not promptly diagnosed and managed.

Observation:

  • This case report details an 11-year-old male presenting with symptoms suggestive of a posterior fossa mass.
  • The patient exhibited cerebral edema and a cerebellar lesion, complicated by acute obstructive hydrocephalus.
  • These findings were attributed to hypertensive encephalopathy.

Findings:

  • The cerebellar lesion and obstructive hydrocephalus were successfully managed with cerebrospinal fluid diversion (shunt insertion) and strict blood pressure control.
  • Resolution of the hydrocephalus and cerebellar swelling was observed following blood pressure normalization.
  • The cerebellar lesion, initially suspected to be a glioma, demonstrated reversibility.

Implications:

  • This case highlights the rare but reversible presentation of cerebellar lesions and hydrocephalus secondary to hypertensive encephalopathy in children.
  • It underscores the importance of considering hypertensive encephalopathy in the differential diagnosis of pediatric posterior fossa lesions, especially when accompanied by hydrocephalus.
  • Early recognition and management of elevated blood pressure are crucial to prevent misdiagnosis and ensure favorable outcomes, avoiding unnecessary oncological interventions.

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