Hypertensive encephalopathy

Chester, Edward M.; Agamanolis, Dimitris P.; Banker, Betty Q.; Victor, Maurice

doi:10.1212/wnl.28.9.928

Cited by 204 publications

(92 citation statements)

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“…All of the stroke foci were easily determined under microscopic examination. Disseminated edema and petechial hemorrhages in the brain, which usually occur in hypertensive encephalopathy, 19,20 were not found in the RHR with stroke. Therefore, the 2k2c RHR with a high incidence of spontaneous stroke can be used as strokeprone renovascular hypertensive rats (RHRSP) independent of a genetic deficiency.…”

Section: Discussionmentioning

confidence: 77%

“…These lesions in the brain are similar to those of hypertensive encephalopathy in humans. 19,20 Stroke foci were observed in all rats in the 1k1c and 2k1c groups and in 31 of 35 rats in the 2k2c group that died suddenly or with symptoms after postoperative week 6. Stroke foci were also observed in 1 of 8, 2 of 27, and 3 of 20 surviving RHR without symptoms in the 1k1c, 2k1c, and 2k2c groups, respectively.…”

Section: Cerebral Lesionsmentioning

confidence: 89%

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Two-Kidney, Two Clip Renovascular Hypertensive Rats Can Be Used as Stroke-prone Rats

Zeng

Zhang

et al. 1998

Stroke

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Background and Purpose-The cerebrovascular lesions in stroke-prone spontaneously hypertensive rats are not only dependent on high blood pressure but partly related to pressure-independent genetic factors. The aim of the present study was to observe whether spontaneous stroke occurred in renovascular hypertensive rats without a genetic deficiency. Methods-The 1-kidney, 1 clip (1k1c); 2-kidney, 1 clip (2k1c); and 2-kidney, 2 clip (2k2c) methods were used to induce hypertension in male Sprague-Dawley rats with a ring-shaped silver clip. Sham-operated rats were used as controls. Blood pressure and neurological symptoms were observed in the rats without any artificial inducement. Brain sections stained with hematoxylin-eosin and phosphotungstic acid-hematoxylin were examined under a microscope to determine stroke foci. Results-The attack rate of stable hypertension was 100% (55/55) in the 2k2c group, which was significantly higher than that in the 1k1c (23/30, 76.7%) and 2k1c (21/30, 70%) groups (PϽ0.01). None of the rats in the 2k2c group died of acute renal failure or suffered from diffuse cerebral lesions postoperatively. Forty weeks after renal artery constriction, the incidence of spontaneous stroke in the 2k2c group was 61.8% (34/55), which was significant higher than that in the 1k1c (7/30, 23.3%) and 2k1c (5/30,16.7%) groups (PϽ0.01). Stroke foci were not observed in normotensive controls. Conclusions-We conclude that 2k2c renovascular hypertensive rats with proper renal artery constriction can be used as stroke-prone renovascular hypertensive rats independent of a genetic deficiency. (Stroke. 1998;29:1708-1714.)

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Section: Discussionmentioning

confidence: 77%

Section: Cerebral Lesionsmentioning

confidence: 89%

Two-Kidney, Two Clip Renovascular Hypertensive Rats Can Be Used as Stroke-prone Rats

Zeng

Zhang

et al. 1998

Stroke

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“…27 Pathological changes observed in rat brain are similar to those found in brains of humans with malignant hypertension, eg, hypertrophied vessels, necrosis of vessel walls, hemorrhages, and infarcts. 28,29 MRI has been useful for studying hypertensive patients. Brain edema and focal ischemic or hemorrhagic lesions characterized by changes on T2-weighted imaging in the clinical setting are similar to those described here.…”

Section: Discussionmentioning

confidence: 99%

Serial Magnetic Resonance Imaging of Rat Brain After Induction of Renal Hypertension

Bigio

Yan²,

Kozłowski³

et al. 1999

Stroke

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Background and Purpose-Hypertension is a major risk factor for ischemic and hemorrhagic stroke and may also cause more chronic and subtle brain injury. Progressive brain changes in a rat model of renal hypertension have been assessed to better understand the pathogenesis of hypertensive brain damage. Methods-Young adult rats were made hypertensive by partial occlusion of both renal arteries. MR images of brain were obtained weekly, and histopathological outcome was assessed. A separate group of rats was used to measure brain specific gravity and Evans blue dye content as an indicator of extravasation. Results-Rats developed maximal mean systolic blood pressures of 173 to Ͼ300 mm Hg, reaching a plateau in 6 to 8 weeks. Rats whose mean systolic pressure never exceeded 210 mm Hg never had brain lesions, while rats whose mean systolic pressure exceeded 276 mm Hg consistently developed brain lesions. Brain T2 values increased with increasing blood pressure. Lesions seen on MRI corresponded to those seen histologically. MRI also demonstrated transient brain expansion, probably due to diffusely increased water content, and rarely demonstrated focal cortical edema, which had no histological correlate. These transient phenomena, as well as hemorrhagic and ischemic infarcts, occurred mainly during the phase of climbing blood pressure and early stages of stable hypertension. Conclusions-Serial MRI reveals aspects of hypertensive brain disease that cannot be studied by histological examination alone.The observed phenomena are likely related to loss of autoregulation and/or blood-brain barrier integrity. Breach of blood vessel integrity is less likely once the vessels become accustomed to high pressures. (Stroke. 1999;30:2440-2447.)

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“…[6][7][8]35,[89][90][91][92][93] Areas of deep white matter abnormality have been noted, which may overlap with lacunar disease and may relate to the known histologic findings in hypertension. 8,93,94 Hemispheric PRES patterns have been reported as well as isolated reversible brain stem and cerebellar edema, occasionally resulting in obstructive hydrocephalus.…”

Section: 69mentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features

Bartynski¹

2008

AJNR Am J Neuroradiol

956

890

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SUMMARY:Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique CT or MR imaging appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune disease and high dose chemotherapy) the imaging, clinical and laboratory features of this toxic state are becoming better elucidated. This review summarizes the basic and advanced imaging features of PRES, along with pertinent features of the clinical and laboratory presentation and available histopathology. Many common imaging/clinical/laboratory observations are present among these patients, despite the perception of widely different associated clinical conditions.

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Hypertensive encephalopathy

Cited by 204 publications

References 0 publications

Two-Kidney, Two Clip Renovascular Hypertensive Rats Can Be Used as Stroke-prone Rats

Two-Kidney, Two Clip Renovascular Hypertensive Rats Can Be Used as Stroke-prone Rats

Serial Magnetic Resonance Imaging of Rat Brain After Induction of Renal Hypertension

Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features

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