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Hypertensive encephalopathy in children
B V Jones1, J C Egelhoff, R J Patterson
1Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Hypertensive encephalopathy in children is uncommon and may be underdiagnosed. Imaging findings, including MR perfusion, suggest vasodilation plays a key role in this condition.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Critical Care Medicine
Background:
- Hypertensive encephalopathy (HE) is a rare neurological condition characterized by severe hypertension leading to brain dysfunction.
- Its occurrence in children is infrequently reported, potentially leading to underdiagnosis and delayed treatment.
Observation:
- This study details five pediatric cases of hypertensive encephalopathy.
- Three cases included Magnetic Resonance (MR) imaging, and two utilized Computed Tomography (CT) scans.
- One patient underwent MR perfusion imaging, revealing abnormalities consistent with vasodilation.
Findings:
- MR perfusion imaging findings support vasodilation as a primary mechanism in pediatric hypertensive encephalopathy.
- Characteristic neuroimaging lesions in severely hypertensive children are indicative of HE.
- The true prevalence of HE in pediatric populations may be underestimated.
Implications:
- Recognition of characteristic imaging findings is crucial for diagnosing HE in children.
- Prompt management should target the underlying hypertension and its causes.
- Further research is needed to understand the full scope and pathophysiology of HE in pediatric patients.
Abstract:
We present five cases of hypertensive encephalopathy in children, three with MR imaging findings and two with CT findings alone. One of the five patients had MR perfusion imaging, which showed perfusion abnormalities that support the concept of vasodilation as the major contributor to the syndrome. Hypertensive encephalopathy is rarely reported in children, and its true prevalence may be underestimated. Characteristic lesions in the severely hypertensive child should be recognized as manifestations of hypertensive encephalopathy, and subsequent clinical management should focus on treatment of the hypertension and/or its underlying causes.