Reversible brain lesions in childhood hypertension.
Posterior leukoencephalopathy syndrome is characterized by an acute, usually reversible, encephalopathy with transient occipital lobe abnormalities detected on MRI that occur mostly in association with acute hypertension. The clinical presentation includes seizures, headache, altered mental status and blindness. Disturbed autoregulation of cerebral blood flow and endothelial injury are central to the pathogenesis of this disorder. Prompt control of hypertension results in rapid and complete neurological recovery. In this report we discuss the cases of two children with acute onset hypertension of different aetiologies that presented with the characteristic features of posterior leukoencephalopathy syndrome.


CONCLUSIONS
Early recognition of this readily treatable condition may obviate the need for extensive and invasive investigations. Despite the alarming lesions on the MRI, prompt control of hypertension carries a uniformly favourable prognosis.
Singhi
P
P
Department of Pediatrics. Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsinghi@glide.net.in
Subramanian
C
C
Jain
V
V
Singhi
S
S
Ray
M
M
D000208:Acute Disease; D000927:Anticonvulsants / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001921:Brain / Q000473:pathology*; D001929:Brain Edema / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004829:Epilepsy, Generalized / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006974:Hypertension, Malignant / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000473:pathology* / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D013577:Syndrome; D016896:Treatment Outcome
D000927:Anticonvulsants; D000959:Antihypertensive Agents