Diffuse leukoencephalopathy in a 29-year-old male with hypertensive emergency

Abstract

Severe hypertension is associated with multiple symptoms that reflect the end-organ damage effect of rapidly increasing blood pressure. Encephalopathy is a manifestation of the clinical spectrum of hypertensive emergencies. Hypertensive encephalopathy was initially described as part of the posterior reversible encephalopathy syndrome, which mostly involved the parieto-occipital white matter of the brain. A more detailed review of this syndrome reveals many cases where the brain abnormalities are distributed in a more random pattern. We describe a case of diffuse leukoencephalopthy in a young male who presented with altered mental status, ataxia, and blurred vision. This is the most diffuse brain involvement ever described in hypertensive statuses.

Posterior Reversible Encephalopathy Syndrome: A Complication of Acute Renal Failure in a Child

“…Thus, the frontal and temporal lobes may be affected, and more rarely the cerebellum and brainstem. 6 The calcarine scissure and the paramedian occipital regions are most often spared. PRES is characterized by the reversibility of the lesions.…”