Hypertensive brainstem encephalopathy: Three cases presenting with severe brainstem edema

Chang, Gregory Youngnam; Keane, James R.

doi:10.1212/wnl.53.3.652

Cited by 73 publications

(41 citation statements)

References 5 publications

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“…[19][20][21] The resulting patients (n ϭ 31) were then submitted for the staff neuroradiologists' review as long as SWI, FLAIR, and DWI were performed, which were standard sequences in all of our brain MR imaging protocols. Additionally, we reviewed each patient's medical record for history of a coagulative disorder, low platelet count (Ͻ100,000), high INR (Ͼ1.5), and whether the patient was on any anticoagulant medication (including either heparin, warfarin, or enoxaparin), because an increased frequency of PRES has been noticed in patients on anticoagulative medication or having bleeding diatheses.…”

Section: -4mentioning

confidence: 99%

Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging

McKinney¹,

Sarıkaya

Gustafson

et al. 2012

AJNR Am J Neuroradiol

122

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Section: -4mentioning

confidence: 99%

Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging

McKinney¹,

Sarıkaya

Gustafson

et al. 2012

AJNR Am J Neuroradiol

122

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“…This combination resulted in the discrepancy between the absence of clinical findings and the obvious radiological findings of hypertensive encephalopathy, expressed as``the patient looking better than the MR images.'' 4) Both our patients had hypertensive brainstem encephalopathy (HBE) without parieto-occipital lesions. 4) Similar MR imaging distributions of lesions in the brainstem with hypertensive encephalopathy but in the absence of parieto-occipital lesions have been reported in 16 patients (Table 1).…”

Section: Discussionmentioning

confidence: 87%

Hypertensive Brainstem Encephalopathy Without Parieto-occipital Lesion-Two Case Reports-

Doi

Kimura

Fujiyama

et al. 2006

Neurol. Med. Chir.(Tokyo)

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Two patients presented with malignant hypertension associated with encephalopathy predominantly manifesting as brainstem lesion. T 2 -weighted and fluid-attenuated inversion recovery magnetic resonance (MR) imaging revealed diffuse hyperintense areas in the pons and scattered lesions in the cerebellum, basal ganglia, and cerebral subcortex without parieto-occipital lesions. Diffusion-weighted MR imaging demonstrated these lesions as normal intensity, indicating vasogenic edema. These lesions resolved rapidly once hypertension was controlled. Review of clinical findings for 14 other patients with hypertensive brainstem encephalopathy without parieto-occipital lesions suggested that anterior circulation structures supplied by the carotid artery are frequently involved in such patients.

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“…There have been few case reports of involvement of the brainstem in PRES 1011. The involvement of medulla oblongata and especially the cervical cord, however, is very rare 4.…”

Section: Discussionmentioning

confidence: 99%

Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome

Choh

Jehangir

Rasheed

et al. 2011

Annals of Saudi Medicine

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The posterior reversible encephalopathy syndrome (PRES) is characterized by patchy cortical and subcortical lesions in the distribution of the posterior circulation. The lesions are classically reversible. This syndrome has multiple etiologies, most of which cause acute hypertension. We present a case of PRES with involvement of the medulla and cervical cord (apart from the typical parieto-occipital lesions)-an extremely rare imaging manifestation of PRES. It is important to recognize the imaging findings of PRES in spinal cord, and avoid misdiagnosis as myelitis by proper clinical correlation. Typically patients with myelitis have a profound neurodeficit, while patients with spinal manifestations of PRES are asymptomatic. Involvement of the cord in PRES has probably been an underrecognized entity as spinal imaging is not routinely performed in posterior reversible encephalopathy syndrome.

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Hypertensive brainstem encephalopathy: Three cases presenting with severe brainstem edema

Cited by 73 publications

References 5 publications

Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging

Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging

Hypertensive Brainstem Encephalopathy Without Parieto-occipital Lesion-Two Case Reports-

Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome

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