In accelerated hypertension, vasogenic brain edema associated with PRES may represent either autoregulatory breakthrough leading to vasodilation or excessive autoregulation leading to vasoconstriction. We describe 2 patients with PRES in accelerated hypertension who had serous retinal detachments, a vasoconstrictive phenomenon. The concurrence of serous retinal detachment and PRES offers intrig...

A 42-year-old man was admitted to the hospital because of increasing difficulty with gait and recent loss of vision. Examination revealed a blood pressure of 250/150 mm Hg, normal mental status , and severe hypertensive retinopathy bilaterally. There was no papilledema, and the fundi were pale. Cranial nerve, motor, and sensory examinations were normal. Plantar reflexes were extensor bilaterall...

ir, We are presenting here a case of an elderly, 60-year-old man who presented to the emergency department in an unconscious state. He had no previous history of diabetes mellitus or hypertension, and there was no history of trauma. On examination he was found to have bilateral papilloedema. His blood pressure at the time of presentation was 220/150 mmHg. The routine laboratory investigations w...

BACKGROUND The "posterior reversible leukoencephalopathy" syndrome, generally observed in the setting of severe, acute hypertension, often correlates with radiological abnormalities that involve the occipital lobes and other hemispheric areas. A predominant involvement of the brainstem in this syndrome is rare. PATIENTS We report three patients with previously known or newly diagnosed severe ...

A 35-year-old male physician, who worked in a Scottish hospital , became unwell while attending a medical conference in the north of England. His colleagues and family became concerned when they were unable to establish contact with him, prompting a search of the conference facilities. He was found drowsy and confused in his hotel bedroom. This presentation was preceded by 7 weeks of blurred vi...

Letters to the Editor will be published, if suitable, as space permits. They should not exceed 1000 words (typed double-spaced) in length and may be subject to editing or abridgment. Intravenous nitroglycerin is a well-recognized treatment of acute hypertension and hypertensive encephalopathy. 1 We are reporting a patient presented with posterior reversible encepha-lopathy syndrome (PRES) secon...

THE LANCET • Vol 356 • July 29, 2000 411 A hypertensive emergency is defined as a situation that requires immediate blood-pressure reduction (not necessarily to .normal values) to prevent or limit targetorgan damage, and a hypertensive urgency is defined as a situation in which blood pressure should be lowered within a few hours. The distinction between emergencies and urgencies is important be...

Variceal bleeding is one of the dreaded complications of portal hypertension. Although its prognosis has improved over the last several decades, it still carries substantial mortality. Although most portal hypertensive bleeds result from the ruptured distal esophageal varices, bleeding from other sources such gastric varices, portal hypertensive gastropathy, and ectopic varices can lead to clin...