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Diagnosis and treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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