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Chronic hypertensive encephalopathy

Case contributed by Assoc Prof Frank Gaillard

Presentation

Short stride length and some parkinsonian features. Cognitive decline.

Patient Data

Age: 70 years
Gender: Female

Susceptibility weighted imaging demonstrates numerous microhemorrhages mostly scattered throughout the basal ganglia, thalami, pons and cerebellar hemispheres. Hemorrhagic lacunae are seen in the left striatum and right corona radiata. Extensive chronic small vessel ischemic change. There is generalized volume loss without a particular lobar pattern associated with ex vacuo dilatation of the ventricles. The midbrain is normal in size. Hippocampi are commensurate to the remainder of the brain.

Case Discussion

This patient had a known and well documented long history of poorly controlled hypertension. The imaging features are typical of chronic hypertensive encephalopathy and prominent chronic small vessel ischemic change. 

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Case information

rID: 72844
Published: 6th Apr 2020
Last edited: 6th Apr 2020
Inclusion in quiz mode: Included

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