van Vught A J, Troost J, Willemse J
Neuropadiatrie. 1976 Feb;7(1):92-100. doi: 10.1055/s-0028-1091612.
Oppenheimer and Fischberg's vasoconstriction-hypothesis on the pathogenesis of hypertensive encephalopathy was subsequently supported by animal experiments. Later on the role of decompensation of the autoregulatory mechanism of the cerebral blood flow was revealed. The transient symptomatology comprises headache, seizures, focal cerebral symptoms (hemiplegia etc.), visual disturbances, mental disorders, papiledema etc. The age-dependency of the influence of edema is probably expressed by the predominance of seizures in childhood and the long duration of the symptoms in our third and fourth patient. The differentiation between hypertensive encephalopathy and a local complication of hypertension (hemorrhage) can be difficult, not at least because the first disturbance may be followed by the second (patient 3). Hypertension is not always present as initial symptom (patient 1 and 2). Hence a series of blood pressure readings is required in acute cerebral incidents in childhood. Steroid-treatment may lead, especially in patients suffering from a hypocomplementemic form of membranoproliferative glomerulonephritis, to a sudden rise of the blood pressure and subsequently to hypertensive encephalopathy (patients 2 and 3). Hypertensive encephalopathy is a neuropediatric emergency. The urgent treatment with dioxaside, fursemide and sodium nitroprusside is shortly reviewed.
奥本海默和菲施贝格关于高血压脑病发病机制的血管收缩假说随后得到了动物实验的支持。后来发现了脑血流自动调节机制失代偿的作用。短暂症状包括头痛、癫痫发作、局灶性脑症状（偏瘫等）、视觉障碍、精神障碍、视乳头水肿等。水肿影响的年龄依赖性可能表现为儿童期癫痫发作占主导，以及我们的第三和第四例患者症状持续时间长。高血压脑病与高血压局部并发症（出血）的鉴别可能很困难，至少部分原因是第一种紊乱可能继发第二种情况（患者3）。高血压并不总是作为初始症状出现（患者1和2）。因此，在儿童急性脑事件中需要多次测量血压。类固醇治疗，尤其是在患有低补体血症型膜增生性肾小球肾炎的患者中，可能导致血压突然升高，继而引发高血压脑病（患者2和3）。高血压脑病是一种小儿神经急症。简要回顾了用二氮嗪、速尿和硝普钠进行的紧急治疗。
