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Nephrol Dial Transplant (2003) 18: 2424-2427
© 2003 European Renal Association-European Dialysis and Transplant Association

Case Report

Hypertension, cerebral oedema and fundoscopy

Rene C. Bakker, Cornelis A. Verburgh, Mark A. van Buchem and Leendert C. Paul

Department of Nephrology, Leiden University Medical Centre, Leiden, The Netherlands

Correspondence and offprint requests to: Dr R. C. Bakker, Department of Nephrology, C3-P, Leiden University Medical Centre, PO Box 9600 2300 RC Leiden, The Netherlands. Email: renebakker@amphia.nl

Keywords: cerebral oedema; fundoscopy; hypertensive encephalopathy; malignant hypertension; reversible posterior leukoencephalopathic syndrome

The first 150 words of the full text of this article appear below.



   Introduction
 
In 1914, the German physicians Volhard and Fahr introduced the name ‘maligne Form der Hypertonie’ for a syndrome consisting of a severe elevation in blood pressure (BP) accompanied by signs of acute end-organ damage [1]. They noted that neurological signs and symptoms were often part of the clinical picture and emphasized the serious prognostic importance of certain fundoscopic changes. By analogy the term ‘malignant hypertension’ was applied by Keith and Wagener in 1921 when they observed papilloedema in patients with severe hypertension [2]. In 1928, Oppenheimer and Fishberg described a 19-year-old college student who suffered from severe hypertension coinciding with repeated bouts of headache, neurological deficits and convulsions and first used the term ‘hypertensive encephalopathy’ (HE) [3]. Although the characteristic retinal signs of malignant hypertension were not present at presentation but developed later in the course of the illness, fundoscopy became a very useful . . . [Full Text of this Article]



   Case 1
 


   Case 2
 


   Case 3
 


   Discussion
 

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