link
Bookmarks
Chronic Hypertensive Encephalopathy
Miral D. Jhaveri, MD; James M. Provenzale, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
5
15
0

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Chronic hypertensive encephalopathy (CHE)
            • Synonyms

              • Subcortical arteriosclerotic encephalopathy
                • a.k.a. Binswanger disease
              • Hypertension-related microvascular disease
            • Definitions

              • Brain parenchymal changes due to longstanding effects of untreated or poorly treated systemic hypertension (HTN)
                • CHE is most common cause of leukoaraiosis (diffuse rarefaction of white matter)
                  • Others include diabetes
              • CHE: Important cause of cognitive deficits caused by vascular disease (i.e., vascular dementia)

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Prins ND et al: White matter hyperintensities, cognitive impairment and dementia: an update. Nat Rev Neurol. 11(3):157-165, 2015
                                            2. van Dalen JW et al: Cortical microinfarcts detected in vivo on 3 Tesla MRI: clinical and radiological correlates. Stroke. 46(1):255-7, 2015
                                            3. Marsh EB et al: Predicting symptomatic intracerebral hemorrhage versus lacunar disease in patients with longstanding hypertension. Stroke. 45(6):1679-83, 2014
                                            4. Ritz K et al: Cause and mechanisms of intracranial atherosclerosis. Circulation. 130(16):1407-14, 2014
                                            5. Cheng AL et al: Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting microbleeds. Stroke. 44(10):2782-6, 2013
                                            6. Wardlaw JM et al: Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 12(5):483-97, 2013
                                            7. Bastos-Leite AJ et al: Cerebral blood flow by using pulsed arterial spin-labeling in elderly subjects with white matter hyperintensities. AJNR Am J Neuroradiol. 29(7):1296-301, 2008
                                            8. Della Nave R et al: Whole-brain histogram and voxel-based analyses of diffusion tensor imaging in patients with leukoaraiosis: correlation with motor and cognitive impairment. AJNR Am J Neuroradiol. 28(7):1313-9, 2007
                                            9. O'Sullivan M et al: Diffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis. J Neurol Neurosurg Psychiatry. 75(3):441-7, 2004
                                            10. Wardlaw JM et al: Is breakdown of the blood-brain barrier responsible for lacunar stroke, leukoaraiosis, and dementia? Stroke. 34(3):806-12, 2003
                                            11. Catani M et al: Proton magnetic resonance spectroscopy reveals similar white matter biochemical changes in patients with chronic hypertension and early Alzheimer's disease. J Am Geriatr Soc. 50(10):1707-10, 2002
                                            Related Anatomy
                                            Loading...
                                            Related Differential Diagnoses
                                            Loading...
                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Chronic hypertensive encephalopathy (CHE)
                                                      • Synonyms

                                                        • Subcortical arteriosclerotic encephalopathy
                                                          • a.k.a. Binswanger disease
                                                        • Hypertension-related microvascular disease
                                                      • Definitions

                                                        • Brain parenchymal changes due to longstanding effects of untreated or poorly treated systemic hypertension (HTN)
                                                          • CHE is most common cause of leukoaraiosis (diffuse rarefaction of white matter)
                                                            • Others include diabetes
                                                        • CHE: Important cause of cognitive deficits caused by vascular disease (i.e., vascular dementia)

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Prins ND et al: White matter hyperintensities, cognitive impairment and dementia: an update. Nat Rev Neurol. 11(3):157-165, 2015
                                                                                      2. van Dalen JW et al: Cortical microinfarcts detected in vivo on 3 Tesla MRI: clinical and radiological correlates. Stroke. 46(1):255-7, 2015
                                                                                      3. Marsh EB et al: Predicting symptomatic intracerebral hemorrhage versus lacunar disease in patients with longstanding hypertension. Stroke. 45(6):1679-83, 2014
                                                                                      4. Ritz K et al: Cause and mechanisms of intracranial atherosclerosis. Circulation. 130(16):1407-14, 2014
                                                                                      5. Cheng AL et al: Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting microbleeds. Stroke. 44(10):2782-6, 2013
                                                                                      6. Wardlaw JM et al: Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 12(5):483-97, 2013
                                                                                      7. Bastos-Leite AJ et al: Cerebral blood flow by using pulsed arterial spin-labeling in elderly subjects with white matter hyperintensities. AJNR Am J Neuroradiol. 29(7):1296-301, 2008
                                                                                      8. Della Nave R et al: Whole-brain histogram and voxel-based analyses of diffusion tensor imaging in patients with leukoaraiosis: correlation with motor and cognitive impairment. AJNR Am J Neuroradiol. 28(7):1313-9, 2007
                                                                                      9. O'Sullivan M et al: Diffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis. J Neurol Neurosurg Psychiatry. 75(3):441-7, 2004
                                                                                      10. Wardlaw JM et al: Is breakdown of the blood-brain barrier responsible for lacunar stroke, leukoaraiosis, and dementia? Stroke. 34(3):806-12, 2003
                                                                                      11. Catani M et al: Proton magnetic resonance spectroscopy reveals similar white matter biochemical changes in patients with chronic hypertension and early Alzheimer's disease. J Am Geriatr Soc. 50(10):1707-10, 2002