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Hypertensive Encephalopathy - Case 2

A 64 year-old woman developed bilateral visual loss and headache. She had hypertension and had not taken her medications for three months. Her blood pressure was 201/134 on arrival to the emergency room.

Outline the Lesions

Hypertensive Encephalopathy (Reversible Posterior Leukoencephalopathy): Flair axial MRIs. Note the multifocal bright signal areas in several areas of the brain, especially in the posterior occipital regions. Hypertensive encephalopathy may result from untreated primary hypertension (as in this case), but is also seen in other conditions associated with hypertension, such as eclampsia and systemic lupus erythematosus. Its common association with edema in the posterior areas of the brain (as seen above) often results in cortical blindness. Treated early, the visual symptoms may be reversible.

Revised 11/04/06
Copyrighted 2006. David C Preston