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KMID : 0371620080230020123
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Journal of Wonkwang Medical Science
2008 Volume.23 No. 2 p.123 ~ p.126
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Reversible Brainstem Hypertensive Encephalopathy In Alcoholics
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Jeong Ju-Lie
Son Il-Hong
Yang Hyun-Duk
Lee Sung-Ik
Han Sun-Jung
Kang Hyun-Gu
Kang Sung-Won
Lee Jai-Kyoo
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Abstract
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Hypertensive encephalopathy is an acute neurological syndrome caused by an abrupt and dramatic rise in blood pressure. The most common abnormality on neuroimaging of the syndrome is presumed edema involving the white matter in the posterior regions of the cerebral hemispheres, especially bilaterally in the parieto-occipital areas. But rarely abnormality on neuroimaging involved the brainstem. A 42-year-old heavy alcoholics man presented with blurred vision, dysarthria, and left-sided weakness for 1 day. Another 62-year-old heavy alcoholics man presented with blurred vision, confusion, and dizziness for 3 days. Two patients had hypertension and took brain MRI examination at admission and follow-up. Brain MRI performed at admission showed the high signal intensity in brain stem on T2 weighted image and Fluid attenuated inversion recovery(FLAIR). Follow-up MRI showed the normal signal intensity in same area onT2 weighted image and FLAIR. We describe the clinical and neuroimaging features of two patients with reversible hypertensive brainstem encephalopathy in alcoholics. It is difficult to explain exactly the relation between chronic alcoholics and posterior reversible leukoencephalopathy syndrome(PRES) in brain stem, but these findings are suggestive of vulnerability to hypertensive encephalopathy in chronic alcoholic brainstem.
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KEYWORD
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Hypertensive encephalopathy, brain stem, alcohol, PRES
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