Revised: July 19, 2013
Accepted: August 8, 2013
Published online: September 28, 2013
Hypertensive brain stem encephalopathy (HBE) is a rare, under diagnosed subtype of hypertensive encephalopathy (HE) which is usually reversible, but with a potentially fatal outcome if hypertension is not managed promptly. To the best of our knowledge, only one case of HE with brain stem hemorrhage has been reported. We report a case of HBE with pontine hemorrhage in a 36-year-old male patient. The patient developed severe arterial hypertension associated with initial computed tomography showing the left basilar part of pons hemorrhage, fluid-attenuated inversion-recovery showing hyperintense signals in the pons and bilateral periventricular, anterior part of bilateral centrum ovale. The characteristic clinical findings were walking difficulty, right leg weakness, and mild headache with nausea which corresponded to the lesions of MR imagings. The lesions improved gradually with improvements in hypertension, which suggested that edema could be the principal cause of the unusual hyperintensity on magnetic resonance images.
Core tip: Hypertensive brain stem encephalopathy (HBE) is a rare, underdiagnosed subtype of hypertensive encephalopathy. The disease is still not recognized by clinical doctors. The prompt diagnosis and treatment is crucial. Here, we report a case of HBE with pontine hemorrhage in a 36-year-old man. The case will help clinicians to further know about the disease.