Subarachnoid haemorrhage, acute intracerebral haemorrhage, hypertensive encephalopathy
, and acute ischemic stroke require rapid BP reduction.
Preeclampsia-eclampsia: Clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy
A Hypertensive encephalopathy
is a brain swelling caused by a sudden, severe, and persistent elevation in blood pressure in people who have uncontrolled high blood pressure.
The ischemic heart condition associated with incorrect administration of antihypertensive drugs (the maximal blood pressure--BP around 200 mmHg) lead to the development of hypertensive encephalopathy
phenomena, requiring hospitalization.
A Hypertensive encephalopathy
is a swelling of the brain caused by a sudden, severe, and persistent elevation of blood pressure in individuals who have uncontrolled high blood pressure.
While the pathogenesis remains poorly understood, clinical entities with hypertension as a component, such as hypertensive encephalopathy
, pre-eclampsia, eclampsia, renal failure, as well as general anesthesia, systemic lupus erythematosus and several chemotherapeutic agents (cyclosporine, cisplatin, tacrolimus) are known etiologic causes.
Headache can be caused by acute elevation in blood pressure due to hypertensive encephalopathy
, preeclampsia, eclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), or posterior reversible encephalopathy syndrome (PRES), Dr.
9,10) For patients who are not going to receive thrombolysis and do not have concomitant noncerebral hypertensive organ damage (aortic dissection, pulmonary edema, hypertensive encephalopathy
, acute myocardial ischemia, acute renal failure), the guidelines suggest withholding blood pressure treatment unless the systolic blood pressure is >220 mm Hg or the diastolic blood pressure is > 120 mm Hg.
, renal failure, vasculitis, immunosuppressive treatment, and eclampsia have been reported to be major causes of this syndrome (Javad et al.
Several "overlap syndromes"--postpartum cerebral angiopathy, hypertensive encephalopathy
, and reversible posterior leukoencephalopathy syndrome--may show neuroimaging features that are similar to or indistinguishable from those of eclampsia, the authors said (Clin.
Severe life-threatening renal disease (scleroderma renal crisis) develops in approximately 10%-15% of patients with diffuse sclerosis and is characterized by acute onset of kidney failure in the absence of previous kidney disease; abrupt onset of moderate to marked hypertension, often times with at least grade III hypertensive retinopathy; and hypertensive-associated manifestations, including microangiopathic hemolytic anemia, pulmonary edema, headache, blurred vision, and hypertensive encephalopathy
, frequently manifesting with seizures.
Eclampsia is defined as the occurrence of seizures and/or coma resulting from hypertensive encephalopathy
on a background of preeclampsia (1).