title: Acute hypertensive encephalopathy with widespread small-vessel disease at MRI in a diabetic patient: pathogenetic hypotheses.
abstract: We report unusual magnetic resonance imaging (MRI) findings in a diabetic patient with neglected hypertension and hyperglycemia, presenting with seizures and coma. Outcome was fatal despite intensive care. The MRI findings included bilateral insular and temporo-occipital grey and white matter involvement, and numerous, scattered, lacunar-like lesions involving the peripheral and deep white matter, basal ganglia grey matter, and brainstem. Lesions had a low apparent diffusion coefficient, and some enhanced following contrast injection. Hypertensive encephalopathy with widespread and severe acute small-vessel disease was considered. Pathophysiology is discussed.
authors: Department of Radiology, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite Cedex, France.
authors: F
authors: F
authors: Cotton
authors: S
authors: S
authors: Kamoun
authors: F
authors: F
authors: Rety-Jacob
authors: V A
authors: VA
authors: Tran-Minh
authors: N
authors: N
authors: Nighoghossian
authors: M
authors: M
authors: Hermier
mesh_terms: D000208:Acute Disease; D048909:Diabetes Complications / Q000473:pathology*; D005260:Female; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008833:Microcirculation; D008875:Middle Aged