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New Developments in Hypertensive Encephalopathy

  • Joseph B. Miller
  • Kushak Suchdev
  • Namita Jayaprakash
  • Daniel Hrabec
  • Aditya Sood
  • Snigdha Sharma
  • Phillip D. Levy
Hypertension and Emergency Medicine (T Rainer and P Levy, Section Editors)
  • 409 Downloads
Part of the following topical collections:
  1. Topical Collection on Hypertension and Emergency Medicine

Abstract

Purpose of Review

This review summarizes the latest science on hypertensive encephalopathy and posterior reversible encephalopathy syndrome (PRES). We review the epidemiology and pathophysiology of these overlapping syndromes and discuss best practices for diagnosis and management.

Recent Findings

Diagnosis of hypertensive encephalopathy largely relies on exclusion of other neurological emergencies. We review the extensive causes of PRES and its imaging characteristics. Management strategies have not changed substantially in the past decade, though newer calcium channel blockers simplify the approach to blood pressure reduction. While this alone may be sufficient for treatment of hypertensive encephalopathy in most cases, management of PRES also depends on modification of other precipitating factors.

Summary

Hypertensive encephalopathy and PRES are overlapping disorders for which intensive blood pressure lowering is critical. Further research is indicated to both in diagnosis and additional management strategies for these critical conditions.

Keywords

Hypertensive encephalopathy Posterior reversible encephalopathy PRES Hypertensive emergency 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Levy reports grants and funds in part by the National Heart, Lung and Blood Institute, grants from Novartis, Trevena, Cardiorentis, and BMS, and personal fees from Novartis, Trevena, and Cardiorentis, outside the submitted work. The other authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Joseph B. Miller
    • 1
  • Kushak Suchdev
    • 2
  • Namita Jayaprakash
    • 3
  • Daniel Hrabec
    • 1
  • Aditya Sood
    • 4
  • Snigdha Sharma
    • 5
  • Phillip D. Levy
    • 6
  1. 1.Department of Emergency Medicine, Department of Internal MedicineHenry Ford Hospital and Wayne State UniversityDetroitUSA
  2. 2.Department of Neurology, Division of Neurocritical CareWayne State UniversityDetroitUSA
  3. 3.Department of Emergency Medicine, Division of Pulmonary Critical Care MedicineHenry Ford Hospital and Wayne State UniversityDetroitUSA
  4. 4.Department of Internal Medicine, Division of CardiologyWayne State UniversityDetroitUSA
  5. 5.Department of Internal Medicine, Division of Pulmonary Critical CareWayne State UniversityDetroitUSA
  6. 6.Department of Emergency MedicineWayne State UniversityDetroitUSA

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