PMC4898221_01
54-year-old man with hypertensive brainstem encephalopathy. Admission computed tomography (CT) scan: Sequential axial CT images at the level of the upper brainstem show diffuse hypodensity of the upper pons (long black arrow), as well as hypodense areas within the superior cerebellar hemispheres (short black arrows) (A). Hypodense areas are also visible at subthalamic nuclei bilaterally (white arrows) (B). The ambient cistern is obliterated (white arrowhead). The periventricular white matter is diffusely hypodense, in keeping with chronic small-vessel disease (black thick arrows) (C).
gr1.jpg
PMC4898221_01_gr1.jpg
fig1ac
The patient was referred for an emergent brain CT (Fig 1, A-C).
54-year-old man with hypertensive brainstem encephalopathy. Followup computed tomography (CT) scan: Sequential axial CT images at the level of the upper brainstem show almost complete resolution of the hypodense appearance of the upper pons, cerebellum white matter, and subthalamic nuclei bilaterally (A and B). There is reversal of the obliteration of the ambient cistern. The periventricular white matter hypodensity is unchanged (C).
gr2.jpg
PMC4898221_01_gr2.jpg
fig2ac
Followup CT after blood pressure normalization showed almost complete reversal of the brainstem hypodensity and ambient cistern obliteration (Fig 2,A-C).