Clinical Quiz on Hypertensive Crisis
DOI:
https://doi.org/10.60787/tnhj.v10i1-2.38Keywords:
Clinical Quiz, Hypertensive CrisesAbstract
Case History: A 40-year-old man with a 3 months history of progressive headache presented with nausea, vomiting, visual disturbances and an episode of epileptic seizure with loss of consciousness. From his medical history, the patient had been diagnosed as hypertensive and received treatment with beta-blockers in the past, but he discontinued it, 1 year ago. At the time of admission, his blood pressure was elevated to 180/130 mmHg and remained high in several measurements during the first 24 h, despite the prompt start of antihypertensive treatment. MRI of the brain was performed on the admission day demonstrating multiple scattered areas of increased signal intensity on T2-weighted and FLAIR images in both occipital and posterior parietal lobes. There were also similar lesions in both hemispheres of the cerebellum (especially the cerebellar white matter on the left) as well as in the medulla oblongata (Figure 1ac). The lesions were not associated with mass effect and after contrast administration there was no evidence of abnormal enhancement.
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