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Brainstem involvement in hypertensive encephalopathy

Clinical and radiological findings

From the Souers Stroke Institute, Department of Neurology (Drs. Cruz-Flores, de Assis Aquino Gondim, and Leira), St. Louis University School of Medicine; and Neurology Service (Dr. Cruz-Flores), Division John Cochran, Veterans Administration Hospital, St. Louis, MO.

Address correspondence and reprint requests to Dr. Salvador Cruz-Flores, Department of Neurology, St. Louis University Hospital, 3635 Vista Avenue at Grand Boulevard, St. Louis, MO 63110; e-mail: Salvador.cruz-flores{at}tenethealth.com

Predominant brainstem or cerebellar edema is rare in hypertensive encephalopathy and usually affects patients with secondary hypertension. Despite the severity of the radiologic findings, clinical features of brainstem involvement are uncommon. The authors report the clinical and radiologic features of two patients.

Received April 23, 2003. Accepted in final form December 15, 2003.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 27 issue to find the title link for this article.

Presented in part at the 53rd Annual Meeting American Academy of Neurology, May 6–11, 2001, Philadelphia, PA.

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