[Encephalopathy induced by arterial hypertension: clinical, radiological and therapeutical aspects].
BACKGROUND
Neuroradiological features of hypertensive encephalopathy are not yet well-known.


METHODS
The clinical manifestations, neuroradiological aspects and treatment of four patients suffering from hypertensive encephalopathy were studied; special attention was paid to manifestations presented by one patient which appeared representative of the usual manifestations of hypertensive encephalopathy.


RESULTS
The main clinical features were visual disturbances (n = 4); altered consciousness (n = 2) and seizures (n = 3). Visual disturbances resulted from cortical lesions (n = 4) associated with optic nerve damage and retinopathy (n = 2). Cerebral imaging showed low density images (CT scan) and hypersignal (MRI, T2 sequence) located in parieto-occipital cortical ribbon and adjacent white matter from the first 24 hours following the onset of neurologic symptoms. In the studied patient, the abnormal images resolved within 1 month after the onset of the disease. Unilateral infarction of the anterior visual pathway affected two patients in whom: 1) hypertension remaining undetected for a long time was revealed by neurological signs; 2) visual impairment was preceded by an hypotensive episode induced by antihypertensive therapy.


CONCLUSIONS
Neuroradiological features of hypertensive encephalopathy are useful in establishing the diagnosis. A gradual reduction of blood pressure could prevent the risk of visual complications.
Sébire
G
G
Service de neurologie, hôpital de Bicêtre, Le Kremlin, France.
Husson
B
B
Lasser
C
C
Tardieu
M
M
Dommergues
J P
JP
Landrieu
P
P
D000293:Adolescent; D001927:Brain Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed
Encéphalopathie induite par l'hypertension artérielle: aspects cliniques, radiologiques et thérapeutiques.