Nagel S, Köhrmann M, Huttner H B, Schwab S
Neurologische Klinik, Universität Heidelberg.
Nervenarzt. 2006 Apr;77(4):466-9. doi: 10.1007/s00115-005-1995-5.
Hypertensive encephalopathy is a severe complication of hypertensive crisis or malignant hypertonia. We report a case with grave clinical and radiological features. The patient was comatose, with pupillary dysfunction, and initial CT suggested a local intracranial mass with edema. Cranial MRI showed almost completely hyperintensive supratentorial white matter, with edema and midline shift, and hypertensities in cerebellum and brainstem. The patient recovered, and the radiological findings improved after antihypertensive therapy. Hypertensive encephalopathy may be differentiated by MRI, manifests acutely, and is potentially reversible when adequate therapy is rapidly performed.
高血压脑病是高血压危象或恶性高血压的严重并发症。我们报告一例具有严重临床和放射学特征的病例。患者昏迷，伴有瞳孔功能障碍，最初的CT提示局部颅内肿块伴水肿。头颅MRI显示幕上白质几乎完全呈高信号，伴有水肿和中线移位，小脑和脑干也有高信号。患者康复，降压治疗后放射学表现改善。高血压脑病可通过MRI鉴别，起病急，若迅速进行适当治疗则可能可逆。
