Ogawa Osamu, Watanabe Ritsuo, Shimizu Hiroshi, Masani Fumiaki
Department of Cardiology, Niigata Prefectural Central Hospital, Japan.
Intern Med. 2011;50(18):1963-7. doi: 10.2169/internalmedicine.50.5572. Epub 2011 Sep 15.
A young woman who was experiencing repeated convulsions was admitted. The patient's brain magnetic resonance image revealed reversible posterior leukoencephalopathy. Blood pressure fluctuated at times to more than 200 mmHg, and the measurement of the right and left upper arms differed by approximately 70 mmHg. Enhanced computed tomography revealed stenotic lesions of some arteries including the left renal artery. Such findings led to an initial diagnosis of Takayasu arteritis and hypertensive encephalopathy caused by renovascular hypertension. A percutaneous transluminal renal angioplasty was successfully performed. The patient's blood pressure returned to normal value without the use of antihypertensive drugs.
一名反复出现惊厥的年轻女性入院。患者的脑磁共振成像显示可逆性后部白质脑病。血压有时波动超过200 mmHg，左右上臂血压测量值相差约70 mmHg。增强计算机断层扫描显示包括左肾动脉在内的一些动脉存在狭窄病变。这些发现初步诊断为大动脉炎和肾血管性高血压所致的高血压脑病。成功进行了经皮腔内肾血管成形术。患者血压在未使用降压药的情况下恢复到正常水平。
