Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2015; 34(01): 064-067
DOI: 10.1055/s-0035-1547388
Case Report | Relato de Caso
Thieme Publicações Ltda Rio de Janeiro, Brazil

Reversible Obstructive Hydrocephalus from Hypertensive Encephalopathy: A Condition that Neurosurgeons Must Know

Hidrocefalia obstrutiva reversível secundária a encefalopatia hipertensiva: uma condição que o neurocirurgião deve conhecer
Thiago Pereira Rodrigues
1   Medical Resident, Department of Neurosurgery, Paulista School of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
,
Daniel de Araújo Paz
1   Medical Resident, Department of Neurosurgery, Paulista School of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
,
Marcos Devanir Silva da Costa
1   Medical Resident, Department of Neurosurgery, Paulista School of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
,
Fabio Fieni Toso
1   Medical Resident, Department of Neurosurgery, Paulista School of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
,
Maria Elisabeth Matta de Rezende Ferraz
2   Neurologist, Head of Emergency Department of Neurology, Paulista School of Medicine, Unifesp, São Paulo, SP, Brazil
,
Fabricio Correa Lamis
3   Neurosurgeon, Department of Neurology and Neurosurgery, São Paulo School of Medicine, Unifesp, São Paulo, SP, Brazil
,
Marcos Hideki Idagawa
4   Radiologist, Department of Diagnostic Imaging, São Paulo School of Medicine, Unifesp, São Paulo, SP, Brazil
,
Luis Antônio Tobaru Tibana
5   Radiologist, Head of Neuroradiology Sector, Department of Diagnostic Imaging, Paulista School of Medicine, Unifesp, São Paulo, SP, Brazil
,
Nitamar Abdala
6   Professor of Radiology, Head of Department of Diagnostic Imaging, Paulista School of Medicine, Unifesp, São Paulo, SP, Brazil
,
Sergio Cavalheiro
7   Professor, Department of Neurosurgery, Paulista School of Medicine, Unifesp, São Paulo, SP, Brazil
,
Italo Capraro Suriano
8   Neurosurgeon, Head of Emergency Department of Neurology, Paulista School of Medicine, Unifesp, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

02 April 2014

01 November 2014

Publication Date:
29 April 2015 (online)

Abstract

The vasogenic edema in structures of posterior fossa secondary to elevated hydrostatic pressure can cause obstructive hydrocephalus, a condition called “reversible obstructive hydrocephalus from hypertensive encephalopathy.” A case of a 27-year-old woman with arterial hypertension and sign of raised intracranial pressure is reported. Her radiologic studies have showed vasogenic cerebellar edema without structural lesion. This edema leads to obstruction of the cerebral aqueduct. We discuss the clinical and therapeutic aspects of this condition. In this clinical situation, the accurate control of blood pressure is the main goal on medical care, and the need of permanent ventricular shunt is quite infrequent.

Resumo

O edema vasogênico secundário a elevação da pressão hidrostática capilar pode causar hidrocefalia obstrutiva, a chamada Hidrocefalia Obstrutiva Reversível secundária a Encefalopatia Hipertensiva. Nós apresentamos um caso de uma mulher de 27 anos com hipertensão arterial e sinais de hipertensão intracraniana. Sua investigação radiológica evidenciou sinais de edema vasogênico cerebelar bilateral sem lesão estrutural, determinando obstrução do aqueduto cerebral Nós discutimos os aspectos clínicos e terapêuticos deste caso. Nesta condição, o adequado controle da pressão arterial é a principal medida terapêutica, sendo a necessidade de derivação liquórica permanente infrequente.

 
  • References

  • 1 Kumar A, Keyrouz SG, Willie JT, Dhar R. Reversible obstructive hydrocephalus from hypertensive encephalopathy. Neurocrit Care 2012; 16 (3) 433-439
  • 2 Larsen FS, Wendon J. Brain edema in liver failure: basic physiologic principles and management. Liver Transpl 2002; 8 (11) 983-989
  • 3 Kidwell CS, Alger JR, Di Salle F , et al. Diffusion MRI in patients with transient ischemic attacks. Stroke 1999; 30 (6) 1174-1180
  • 4 Hinchey J, Chaves C, Appignani B , et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996; 334 (8) 494-500
  • 5 Edvinsson L, Owman C, Siesjö B. Physiological role of cerebrovascular sympathetic nerves in the autoregulation of cerebral blood flow. Brain Res 1976; 117 (3) 519-523
  • 6 Bhagavati S, Chum F, Choi J. Hypertensive encephalopathy presenting with isolated brain stem and cerebellar edema. J Neuroimaging 2008; 18 (4) 454-456