Diagnosis and treatment
Hypertensive encephalopathy must be distinguished from intracranial tumours, cerebrovascular events and uraemia.
Diagnosis therefore entails:
- serial measurement of high blood pressure
- CT - shows widespread white matter attenuation and excludes most alternative pathology
- MRI or radiographic contrast study } exclusion of
- urinalysis and estimation of blood urea } differentials
Treatment involves:
- aim - gradual reduction of diastolic blood pressure to 100 - 110 mm Hg
- method:
- labetalol, especially in suspected phaeochromocytoma
- nitroprusside or diazoxide by slow iv infusion
- peritoneal dialysis for resistant cases
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