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Course of brain damage following malignant hypertension

Jean Sebastien Liegey1, Antoine Cremer2, Ludovic Lucas3

  • 1Coronary and vascular diseases Department, Bordeaux university Hospital, Bordeaux, France. jean-sebastien.liegey@chu-bordeaux.fr.

Journal of Human Hypertension
|November 2, 2024
PubMed

Insights

Malignant hypertension crises can cause new strokes and hemorrhages, with brain MRI markers evolving over time. Follow-up imaging reveals persistent microvascular changes, impacting patient care.

Area of Science:

  • Neurology
  • Radiology
  • Nephrology

Background:

  • Malignant hypertension (MHT) crises cause significant brain microvascular damage.
  • Limited data exists on the evolution of cerebral injuries after MHT management.
  • Brain MRI markers are crucial for assessing acute and chronic changes.

Purpose of the Study:

  • To investigate the changes in brain MRI markers following acute malignant hypertension crisis.
  • To identify the incidence of new cerebrovascular events and microangiopathy post-MHT.

Main Methods:

  • Retrospective analysis of brain MRI data from MHT patients (2008-2022).
  • Inclusion criteria: at least one follow-up MRI.
  • Analysis focused on PRES, stroke, hemorrhage, and microangiopathy markers.

Main Results:

  • Follow-up MRIs in 47 patients showed new strokes (10.6%) and cerebral hemorrhages (4.3%).
  • No cases of PRES were observed.
  • Increased prevalence of chronic lacunar infarcts and microbleeds; stable Fazekas scores in 66%.

Conclusions:

  • Malignant hypertension crises carry a risk of subsequent cerebrovascular events.
  • Brain MRI markers dynamically change post-MHT, indicating ongoing microvascular impact.
  • Findings support improved diagnosis, personalized treatment, and proactive care for MHT patients.

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