What is Hypertensive Encephalopathy? ^

The hypertensive encephalopathy was introduced to the medical world in the year 1928. It was described as an acute malignant hypertension. Several experts made a clinical investigation about this condition. However, there were no definitive tests used to confirm the problem during that time.

Etiology of Hypertensive Encephalopathy ^

The hypertensive encephalopathy was considered as neurologic problem which is caused by uremic condition. Medical doctors termed it as pseudo-uremia (false uremia). However, there are cases which connect this condition to people with eclampsia (pregnant mothers) and high blood pressure. In 1935, this condition was called as eclamptic uremia.



It occurs to women who are manifesting the signs and symptoms of pregnancy-induced hypertension; and at the same time manifesting the symptoms of encephalopathy. This study was supported in the later part. Through the use of neuroimaging techniques, the case was confirmed and established to the medical world.

The presence of cerebral edema (swelling of the cerebrum) and eclamptic features (seizure attacks) had led to the innovation of surgical procedure. An effective treatment used for treating people with hypertensive encephalopathy is called craniotomy. Craniotomy is a surgical procedure which drills an opening to the skull.  Other surgical procedure is the dural incision which was performed in 1911. Additionally, the spinal taps are performed to relieve the swelling of the cerebrum. This procedure is performed by aspirating the excess fluid which causes the brain to swell.

Hypertensive Encephalopathy Clinical Manifestations ^

The signs and symptoms of hypertensive encephalopathy are more on neurologic manifestations. It can be divided into two distinctive aspects. These are:

  • Focal deficits which are related to chronic hypertension
    • Cerebral vascular disease (stroke)
    • Brain hemorrhage (bleeding)
    • Cerebral dysfunction (malfunctioning brain which may alter the neurologic functioning)
  • Focal deficits which are related to acute hypertension
    • Multi-infarction of the brain (insufficient blood and oxygen supply to the brain tissue)
    • High blood pressure
    • High level of diastolic blood pressure (over 130 mmHg)
    • Rapid high blood pressure reading for people with normal BP
    • Elevated systolic pressure (over 180 to 200 mmHg)

Other clinical manifestations of hypertensive encephalopathy are:

  • Nausea and vomiting (presence of excessive fluid to the brain which may cause dizziness)
  • Confusion (altered level of consciousness)
  • Drowsiness, dizziness, and lightheadedness
  • Seizure (Epileptic event. Commonly occur to pregnant women)

Treatment of Hypertensive Encephalopathy ^

The treatment regimen for hypertensive encephalopathy is the same with treating hypertension and encephalopathy, respectively. These two distinctive health problems may require the use of anti hypertensive (beta-blockers, calcium channel blockers, and beta adrenergic drugs). Antibiotics are given to people who are manifesting the signs and symptoms of encephalitis (inflammation of the brain) which is caused by infective bacteria. Diuretics will be given to promote fluid excretion. This can also lower the blood pressure. However, people who are prescribed with potassium-sparing diuretics should take foods which are rich in potassium. This is to prevent cardiac problems which may be caused by hypokalemia (low level of potassium in the blood).

As a conclusion, the treatment for hypertensive encephalopathy is through proper management of the two health problems. However, these conditions are interrelated to each other. It means that when the hypertension is treated, encephalopathy will be treated, as well.

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