Hypertensive Encephalopathy

Brain damage resulting from malignant hypertension, usually associated with a diastolic blood pressure in excess of 125 mmHg. Clinical manifestations such as including headache, nausea, emesis, seizures, altered mental status, papilledema, and retinal hemorrhage. Focal neurologic signs may develop. Pathologically, this condition may be associated with the formation of ischemic lesions in the brain (brain ischemia)

Causes

The common cause of hypertensive encephalopathy is abrupt blood pressure elevation in the chronically hypertensive patient. Other conditions predisposing a patient to elevated blood pressure can cause the same clinical situation such as includes, Chronic renal parenchymal disease, Acute glomerulonephritis, hepatic encephalopathy, Encephalitis, meningitis, Renovascular hypertension. Which occurs in severe Cirrhosis of the Liver. A form of encephalopathy that has recently received a lot of coverage is Bovine spongiform encephalopathy. Alzheimer's is a non-transmissible variant of Creutzfeldt-Jakob Disease. Withdrawal from hypertensive agents.

Symptoms

• Severe headache
• Vomiting
• Confusion
• Lethargy

Signs

• Markedly elevated blood pressure and abnormal mental status are essential features (mental status may fluctuate).
• Papilledema is usually, if not always, present.
• Fever should suggest another cause, such as meningitis, encephalitis, thyroid storm, or neuroleptic malignant syndrome.

Treatment

Hospitalization is essential until the severe high blood pressure is under control. Medications delivered through an IV line, such as nitroprusside, nitroglycerin and etc. may reduce your blood pressure.

After the severe high blood pressure is under control, anti-hypertensive medications taken by mouth can control your blood pressure. The medication may need to be adjusted occasionally.