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MRI of the brain disclosed noncontrast-enhancing, ill-defined, T2-weighted (T2W) hyperintensities in the white matter of the cerebrum in the areas of the frontal, parietal, temporal, and occipital lobes.
Lesions were also observed in the caudate nuclei and thalamus (n = 1 in each).
Intracranial hemorrhage was observed in one animal.
Diffusion-weighted imaging (DWI) was consistent with vasogenic edema in two animals. Retinal lesions were observed in three animals.
Hypertension was secondary to renal disease in three animals.
A primary underlying disorder was not identified in one animal.
Normalization of blood pressure was achieved with amlodipine either alone or in combination with enalapril.
In one cat, hypertension spontaneously resolved.
In three cases, neurologic improvement occurred within 24–48 hr of normalization of blood pressure.
The presumptive diagnosis of hypertensive encephalopathy was supported by the MRI findings and neurologic dysfunction coincident with systemic hypertension in which the neurologic dysfunction improved with treatment of hypertension.
The prognosis appears good for the resolution of neurologic deficits with normalization of blood pressure in animals with hypertensive encephalopathy.
Source: Jeremy O`Neill, Marc Kent, Eric N. Glass, Simon R. Platt (2013): Clinicopathologic and MRI Characteristics of Presumptive Hypertensive Encephalopathy in Two Cats and Two Dogs
In: Published online before print September 19, 2013, doi: 10.5326/JAAHA-MS-5942 Journal of the American Animal Hospital Association Nov/Dec 2013 jaaha.5942
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