Cranial computed tomographic findings in a patient with hypertensive encephalopathy in acute poststreptococcal glomerulonephritis.

A 13-year-old girl with a severe headache, blurred vision, altered mental status, seizures, high blood pressure, edema and hematuria is presented. With a previous history of upper respiratory tract infection, acute onset of edema, gross hematuria, high ASO and low C3 levels, she was diagnosed with acute poststreptococcal glomerulonephritis (APSGN) and hypertensive encephalopathy. Computed tomography (CT) revealed symmetric hypodense areas representing edema in the parieto-occipital regions. As noted in previous reports, these CT findings are of value in establishing the diagnosis of hypertensive encephalopathy. In this particular case the CT appearance and the subsequent clinical improvement without any neurological deficit supported the diagnosis of hypertensive encephalopathy due to APSGN. We emphasize that awareness of the CT findings of hypertensive encephalopathy may facilitate in making the correct diagnosis in symptomatic hypertensive patients, especially in cases with an unusual presentation or clinical course.