Hypertensive brainstem encephalopathy: clinical and radiographic features

J Neurol Sci. 2003 Apr 15;208(1-2):93-9. doi: 10.1016/s0022-510x(02)00379-9.


Reversible posterior leukoencephalopathy syndrome associated with hypertension rarely presents with predominant involvement of the brainstem and relative sparing of the supratentorial regions. We describe the clinical and neuroimaging features of three patients with reversible hypertensive brainstem encephalopathy. Headache and confusion in the setting of severe hypertension, with a relative paucity of brainstem signs and symptoms, despite extensive neuroimaging abnormalities in the brainstem support the diagnosis. The clinical findings and neuroimaging abnormalities resolve with treatment of the hypertension, further distinguishing this syndrome from brainstem infarction.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Brain Diseases / pathology*
  • Brain Stem / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertensive Encephalopathy / etiology*
  • Hypertensive Encephalopathy / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed