Related Experiment Video
Updated: Jul 7, 2026
04:12
Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
Published on: March 28, 2025
Hypertension-induced reversible posterior leukoencephalopathy syndrome causing obstructive hydrocephalus
S Y Lee1, S K Dinesh, J Thomas
1National Neuroscience Institute, Department of Neurosurgery, Singapore General Hospital Campus, Singapore. seryee54@yahoo.co.uk
Summary
Reversible posterior leukoencephalopathy syndrome (RPLS) can cause severe neurological symptoms. Early diagnosis and treatment, as shown in this case, lead to complete recovery.
Area of Science:
- Neurology
- Radiology
- Critical Care Medicine
Background:
- Reversible posterior leukoencephalopathy syndrome (RPLS) presents with headache, altered mental status, visual disturbances, and seizures.
- Characterized by reversible white matter abnormalities, primarily in the parietal-occipital regions.
- RPLS is associated with conditions like hypertensive encephalopathy, eclampsia, and immunosuppressive therapy.
Observation:
- A patient presented with acute headache, confusion, and uncontrolled hypertension.
- Neuroimaging revealed acute hydrocephalus due to cerebellar and pontine edema.
- The patient developed drowsiness, necessitating intervention.
Findings:
- External ventricular drain insertion for hydrocephalus decompression.
- Aggressive blood pressure management was initiated.
- The patient demonstrated complete clinical and radiological recovery.
Implications:
- This case highlights the potential for complete reversal of RPLS.
- Early diagnosis and prompt, appropriate treatment are crucial for favorable outcomes.
- Effective management of hypertension and cerebral edema is key in RPLS cases.
Related Concept Videos
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:29Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...