Hypertensive encephalopathy: Mechanisms, clinical features, and treatment
| Autor: | Ray W. Gifford, Edward Westbrook |
|---|---|
| Rok vydání: | 1974 |
| Předmět: |
medicine.medical_specialty
Hypertensive encephalopathy Obtundation Ganglionic Blockers Coarctation of the aorta Diagnosis Differential Primary aldosteronism Furosemide Internal medicine Animals Humans Medicine Brain Diseases Eclampsia business.industry Cerebral infarction Diazoxide Brain Electroencephalography Hydralazine medicine.disease Rats Blood pressure Hypertension Cardiology Headaches medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Progress in Cardiovascular Diseases. 17:115-124 |
| ISSN: | 0033-0620 |
| Popis: | T HE TERM hypertensive encephalopathy should be reserved for a dramatic clinical syndrome that occasionally punctuates the course of hypertension, either primary or secondary, manifested by subacute alterations in cerebral function that can be reversed by prompt reduction of blood pressure. Unfortunately, this term has been used erroneously to describe a variety of chronic organic brain syndromes occurring in hypertensive patients including residuals of cerebral hemorrhage or cerebral infarction, senile dementia, cortical atrophy, pseudbbulbar palsy, and others. Hypertensive encephalopathy is a medical emergency that demands prompt diagnosis and aggressive treatment before irreversible brain damage or death ensues. From the clinical standpoint, hypertension is the hallmark of hypertensive encephalopathy. Hypertension may be primary (“essential”) or secondary to chronic renal parenchymal disease, renovascular disease, or pheochromocytoma. Hypertensive encephalopathy is rarely observed, if ever, in patients with coarctation of the aorta or primary aldosteronism. The appearance of cerebral symptoms usually follows sudden onset of hypertension or an abrupt increase in blood pressure in patients with already established hypertension. Symptoms appear at lower levels of blood pressure when hypertension is of recent onset rather than when it is chronic. For example, it is not unusual to observe severe headaches, blurred vision, mental obtundation, nausea, vomiting, and focal neurologic signs (including convulsions), characteristic of hypertensive encephalopathy in children with acute glomerulonephritis or women with eclampsia when the blood pressure is no greater than 160/100 mm Hg. However, this syndrome rarely occurs in chronically hypertensive patients until their blood pressure exceeds 2501150 mm Hg. |
| Databáze: | OpenAIRE |
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