Peer-reviewed veterinary case report
Clinicopathologic and MRI characteristics of presumptive hypertensive encephalopathy in two cats and two dogs.
- Journal:
- Journal of the American Animal Hospital Association
- Year:
- 2013
- Authors:
- O'Neill, Jeremy et al.
- Affiliation:
- Department of Small Animal Medicine and Surgery · United States
Plain-English summary
In this study, two dogs and two cats were seen for sudden changes in behavior, including confusion, lying down more than usual, and blindness. All of them had high blood pressure, with readings between 180 and 260 mm Hg. MRI scans showed unusual areas in the brain's white matter and some had bleeding in the brain. The high blood pressure was often linked to kidney problems, but one animal didn't have a clear cause. After treating the high blood pressure with medication, most of the pets showed improvement in their neurological symptoms within one to two days. Overall, the outlook for recovery from these neurological issues seems positive once blood pressure is controlled.
Abstract
Two dogs and two cats were evaluated for the acute-onset of abnormal mentation, recumbency, and blindness. All cases had systemic hypertension, ranging from 180 mm Hg to 260 mm Hg. 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.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/24051253/