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May 1965

Hypertensive Encephalopathy

Author Affiliations

From the Division of Neurology, Department of Medicine, Kansas University Medical Center.

Arch Neurol. 1965;12(5):472-478. doi:10.1001/archneur.1965.00460290028005

THE CLINICAL entity of seizures and focal neurological signs and symptoms complicating advanced hypertension was formulated as "hypertensive encephalopathy" by Fishberg 40 years ago, and ascribed to a specific mechanism of arterial spasm and cerebral edema. It has been our impression that the cerebral manifestations of many of the cases so diagnosed might well be explained by more familiar and well defined disturbances of brain physiology— such as hemorrhage, infarction, vascular insufficiency, uremia, or electrolyte imbalance. It was therefore decided to review an unselected series of cases diagnosed as hypertensive encephalopathy and to critically evaluate the findings: (1) to determine the accuracy with which Fishberg's diagnostic criteria were met; and (2) to determine if the actual mechanism of brain dysfunction in retrospect was possibly other than angiospasm.

Material and Methods  All cases with a final diagnosis of hypertensive encephalopathy discharged from the Kansas University Medical Center over a ten year

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