Cerebral infarction during hypertensive encephalopathy: Case report with pathologic and atypical radiographic...

Neuroimaging of patients with hypertensive encephalopathy frequently reveals white matter changes that reverse with control of blood pressure. We report a young woman who presented with hypertensive encephalopathy but with unusual radiographic findings. Her course and atypical appearance on magnetic resonance imaging raised suspicion for encephalitis, but autopsy disclosed a large cerebral infarction, an uncommon complication during this clinical syndrome. The discovery of a pheochromocytoma at autopsy was also unexpected and may be associated with the unusual features of this case. The clinical, pathologic, and radiographic descriptions of this case may offer further insight into the pathophysiology of hypertensive encephalopathy.