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Hypertensive Encephalopathy

A reversible neurological emergency presenting with cerebral edema and confusion due to extremely high blood pressure.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Hypertensive Encephalopathy?

Hypertensive encephalopathy is a hypertensive emergency characterized by vasogenic cerebral edema developing as a result of impaired cerebral autoregulation. It commonly affects parieto-occipital white matter (PRES).

Typically presents with acute high blood pressure, severe headache, blurred vision, seizure and altered consciousness. PRES pattern is seen on MRI.

When recognized early, complete recovery is expected with blood pressure control. If delayed, the risk of intracerebral hemorrhage and permanent neurological damage increases.

Symptoms

Progressively worsening severe headache
Confusion and lethargy
Cortical blindness or visual field defect
Nausea, vomiting
Seizure
Muscle weakness
Papilledema (fundus examination)

Risk Factors

Uncontrolled hypertension
Acute glomerulonephritis
Preeclampsia and eclampsia
Immunosuppressant drugs (tacrolimus, cyclosporine)
Thrombotic microangiopathy
Pheochromocytoma
Chronic kidney failure

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Go to emergency immediately with high blood pressure and new headache
  • Call 112 if visual disturbance and altered consciousness accompany
  • Do not delay in hypertensive patient with seizure
  • Apply immediately if high blood pressure and headache occur during pregnancy

Treatment Methods

01
Controlled lowering of MAP with intravenous antihypertensives (nicardipine, labetalol)
02
PRES diagnosis with neuroimaging (MRI/CT)
03
Seizure control (levetiracetam, benzodiazepine)
04
Maintaining electrolyte and fluid balance
05
Treatment of underlying cause (renal, toxic, preeclampsia)
06
Intensive care follow-up

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Acil Servis Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.