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Angiology
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*Brain Diseases
*High Blood Pressure
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Transient Encephalopathy Related to Rapidly and Markedly Elevated Blood Pressure in Acute Stage of Hypertensive Cerebral Hemorrhage — Relationship to Hypertensive Encephalopathy — A Case Report

Osamu Shiokawa

Stroke Care Division, Kyushu Rosai Hospital, Kitakyushu-City, Japan

Alan H. C. Lau

Stroke Care Division, Kyushu Rosai Hospital, Kitakyushu-City, Japan

Seizo Sadoshima

From the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Masatoshi Fujishima

From the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

A seventy-two-year-old man with hypertensive cerebral hemorrhage acutely developed severe headache, nausea, vomiting, agitation, and disorientation with abrupt rise in blood pressure on the sixth day after the onset. At that time, there were no remarkable changes in focal neurologic deficits, and repeated brain CT scans revealed a small hematoma located in the right basal ganglia without further enlargement or herniation. Blood chemistry and arterial gas analysis were within the normal ranges except for a slight rise in blood urea nitrogen. Similar episodes occurred three times within two days, and each time the cere bral symptoms disappeared in accordance with lowering of blood pressure by antihypertensive therapy. Complication of hypertensive encephalopathy was strongly suggested. The authors discuss the pathophysiology of this encephalo pathy in relation to cerebral hemorrhage.

Angiology, Vol. 39, No. 11, 996-1000 (1988)
DOI: 10.1177/000331978803901110
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