Joseph B Miller1, Kushak Suchdev2, Namita Jayaprakash3, Daniel Hrabec4, Aditya Sood5, Snigdha Sharma6, Phillip D Levy7. 1. Department of Emergency Medicine, Department of Internal Medicine, Henry Ford Hospital and Wayne State University, 2799 W Grand Blvd, Detroit, MI, 48202, USA. jmiller6@hfhs.org. 2. Department of Neurology, Division of Neurocritical Care, Wayne State University, Detroit, MI, USA. 3. Department of Emergency Medicine, Division of Pulmonary Critical Care Medicine, Henry Ford Hospital and Wayne State University, Detroit, MI, USA. 4. Department of Emergency Medicine, Department of Internal Medicine, Henry Ford Hospital and Wayne State University, 2799 W Grand Blvd, Detroit, MI, 48202, USA. 5. Department of Internal Medicine, Division of Cardiology, Wayne State University, Detroit, MI, USA. 6. Department of Internal Medicine, Division of Pulmonary Critical Care, Wayne State University, Detroit, MI, USA. 7. Department of Emergency Medicine, Wayne State University, Detroit, MI, USA.
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. 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.
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. 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.
Authors: Corinne Orlando; Gregorio P Milani; Giacomo D Simonetti; Barbara Goeggel Simonetti; Sebastiano A G Lava; Rolf Wyttenbach; Mario G Bianchetti; Marirosa Cristallo Lacalamita Journal: Pediatr Nephrol Date: 2021-09-21 Impact factor: 3.651