Abstract
Results
Three patients with hypertensive encephalopathy presented to our institutions with clinical and radiographic features of obstructive hydrocephalus associated with brainstem and cerebellar edema. This required transient external drainage of cerebrospinal fluid (CSF) in two of the three patients. However, with recognition of this unusual syndrome and aggressive management of elevated blood pressure, both edema and hydrocephalus resolved. All patients made complete recoveries and did not require permanent CSF shunting. A review of the literature yielded 15 additional case reports describing reversible obstructive hydrocephalus related to hypertensive encephalopathy. All had mean arterial pressures above 130 mmHg and presented primarily with altered mental status. While half required ventriculostomy, only one required shunting. Excluding a patient who died from sepsis, all recovered neurologically once blood pressure was controlled.
- Content Type Journal Article
- Category Practical Pearl
- Pages 1-7
- DOI 10.1007/s12028-011-9663-z
- Authors
- Abhay Kumar, Department of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8111, St. Louis, MO 63110, USA
- Salah G. Keyrouz, Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Jon T. Willie, Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Rajat Dhar, Department of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8111, St. Louis, MO 63110, USA
- Journal Neurocritical Care
- Online ISSN 1556-0961
- Print ISSN 1541-6933
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