Encyclopedia of Clinical Neuropsychology

2018 Edition
| Editors: Jeffrey S. Kreutzer, John DeLuca, Bruce Caplan

Hypertensive Encephalopathy

  • Holly Rau
  • Rosemary Ziemnik
  • Yana Suchy
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-57111-9_501

Synonyms

Accelerated hypertension; Hypertensive crisis; Hypertensive emergency; Hypertensive urgency; Malignant hypertension

Definition

Hypertensive encephalopathy occurs secondary to an abrupt, sustained rise of blood pressure that exceeds the limits of cerebral autoregulation, causing leakage of fluid into perivascular tissue and resulting in cerebral edema and increased intracranial pressure.

Current Knowledge

Pathophysiology

In normotensive patients, a mean arterial pressure (MAP) above approximately 60 mm Hg triggers autoregulation. Autoregulation refers to the capacity to maintain cerebral blood flow by fluctuations in the vascular tone of the cerebral resistance arteries. Once MAP approaches 160 mm Hg, autoregulatory mechanisms are less able to sustain control over cerebral blood flow. Patients with chronic hypertension may develop encephalopathy at much higher MAP levels as cerebral autoregulatory range adapts to higher pressures over time. Once the autoregulatory capacity is...

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References and Readings

  1. Blumenfeld, J. D., & Laragh, J. H. (2001). Management of hypertensive crisis: The scientific basis for treatment decisions: Review. American Journal of Hypertension, 14(11er), 1154–1167.PubMedCrossRefGoogle Scholar
  2. Chang, R. C. (2006). Hypertensive encephalopathy.http://www.emedicine.com/med/byname/encephalopathy-hypertensive.htm
  3. Goldman, L., & Ausiello, D. (Eds.). (2007). Cecil medicine (23rd ed.). Philadelphia: Saunders.Google Scholar
  4. Libby, P., Bonow, R. O., Mann, D. L., & Zipes, D. P. (Eds.). (2007). Braunwald’s heart disease: A textbook of cardiovascular medicine (8th ed.). Philadelphia: Saunders.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Holly Rau
    • 1
  • Rosemary Ziemnik
    • 1
  • Yana Suchy
    • 1
  1. 1.Department of PsychologyThe University of UtahSalt Lake CityUSA