Hypertensive brainstem encephalopathy
Updates to Study Attributes
Axial noncontrast CT at the level of the pons demonstrates diffuse hypodensity. This was noted to extend from the upper pons to the superior cerebellar hemispheres. Additionally, the adjacent ambient and basal cisterns are disproportionately small relative to the degree of global cerebral volume loss, suggestive of edema. Remainder
The remainder of the brain was unremarkable..
Updates to Case Attributes
In the literature, hypertensive brainstem encephalopathy is considered on the spectrum of atypical PRES. While not entirely understood, the proposed mechanism is failure of cerebral autoregulation leading to hyperperfusion and vasogenic edema. Brainstem involvement in PRES is not unusual, and has been reported in 13% of patients with PRES.
What makes this case atypical is the isolated brainstem involvement; however, there are several case reports showing similar findings.
The patient in this was case was admitted to the neuro ICU where blood pressure was slowly decreased. Patient
The patient made a full clinical recovery and discharged shortly after.
-<p>In the literature, hypertensive brainstem encephalopathy is considered on the spectrum of atypical PRES. While not entirely understood, the proposed mechanism is failure of cerebral autoregulation leading to hyperperfusion and vasogenic edema. Brainstem involvement in PRES is not unusual, and has been reported in 13% of patients with PRES.</p><p>What makes this case atypical is the isolated brainstem involvement; however, there are several case reports showing similar findings. </p><p>The patient in this was case was admitted to the neuro ICU where blood pressure was slowly decreased. Patient made a full clinical recovery and discharged shortly after.</p>- +<p>In the literature, hypertensive brainstem encephalopathy is considered on the spectrum of atypical PRES. While not entirely understood, the proposed mechanism is failure of cerebral autoregulation leading to hyperperfusion and vasogenic edema. Brainstem involvement in PRES is not unusual, and has been reported in 13% of patients with PRES.</p><p>What makes this case atypical is the isolated brainstem involvement; however, there are several case reports showing similar findings.</p><p>The patient in this was case was admitted to the neuro ICU where blood pressure was slowly decreased.</p><p>The patient made a full clinical recovery and discharged shortly after.</p>
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