Hypertensive encephalopathy: a diagnosis of exclusion

Patients with hypertension and altered neurologic status represent difficult diagnostic problems. If these patients are presumed to have hypertensive encephalopathy, specific diagnostic procedures and therapy may be delayed. Our case report and discussion emphasize the difficulty of differentiating hypertensive encephalopathy from other conditions and illustrate hypertensive encephalopathy should not be a primary diagnosis, but only a diagnosis of exclusion.