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Computed tomographic changes of hypertensive encephalopathy.

K L Weingarten, R D Zimmerman, R S Pinto

    AJNR. American Journal of Neuroradiology
    |May 1, 1985
    PubMed
    Summary
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    Computed tomographic (CT) scans reveal white-matter edema in hypertensive encephalopathy. These brain imaging changes typically resolve after blood pressure control, though some patients may develop permanent infarction.

    Area of Science:

    • Neurology
    • Radiology
    • Nephrology

    Background:

    • Hypertensive encephalopathy involves a rapid, severe blood pressure increase.
    • Symptoms include headache, altered mental status, and focal neurologic deficits.
    • Blood pressure typically ranges from 200-280 mm Hg systolic and 130-170 mm Hg diastolic.

    Purpose of the Study:

    • To evaluate computed tomographic (CT) findings in patients with acute hypertensive encephalopathy.
    • To correlate CT abnormalities with neuropathologic findings.

    Main Methods:

    • Retrospective analysis of CT scans from 11 patients diagnosed with acute hypertensive encephalopathy.
    • Follow-up CT scans were performed in six patients after blood pressure normalization.

    Main Results:

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    • The most frequent CT finding was white-matter edema, affecting supratentorial regions in all patients and infratentorial regions in eight.
    • Edema resolved on follow-up CT in all six patients studied after blood pressure reduction.
    • Three patients showed permanent areas of infarction.

    Conclusions:

    • CT is valuable in diagnosing hypertensive encephalopathy, primarily showing white-matter edema.
    • Edema is reversible with blood pressure control.
    • Permanent infarction can occur in some cases.