HYPERTENSIVE ENCEPHALOPATHY - CLINICORADI OLOGICAL ASPECTS AND TREATMENT

Background. - Neuroradiological features of hypertensive encephalopath y are nos yet well-known. Patients and methods. - The clinical manifes tations, neuroradiological aspects and treatment of four patients suff ering from hypertensive encephalopathy were studied; special attention was paid to manifestations presented by one patient which appeared re presentative of the usual manifestations of hypertensive encephalopath y. Results. - The main clinicalfeatures were visual disturbances (n = 4); altered consciousness (n = 2) and seizures (n = 3). Visual disturb ances resulted from cortical lesions (n = 4) associated with optic ner ve damage and retinopathy (n = 2). Cerebral imaging showed low density images (CT scan) and hypersignal (MRI, T2 sequence) located in pariet o-occipital cortical ribbon and adjacent white matter from the first 2 4 hours following the onset of neurologic symptoms. In the studied pat ient, the abnormal images resolved within I month after the onset of t he disease. Unilateral infarction ofthe anterior visual pathway affect ed two patients in whom: 1) hypertension remaining undetected for a lo ng time was revealed by neurological signs; 2) visual impairement was preceded by an hypotensive episode induced by antihypertensive therapy . Conclusions. - Neuroradiological features of hypertensive encephalop athy are useful in establishing the diagnosis. A gradual reduction of blood pressure could prevent the risk of visual complications.