Hypertension Blog

The signs and symptoms of hypertensive encephalopathy result from a rapid increase in diastolic blood pressure to more than 140 mm Hg and the abrupt onset of hypertension in a patient with no history of hypertension or in one with well-controlled hypertension.

Initially, your patient may complain of a severe, generalized headache and restlessness. This may progress to nausea and projectile vomiting. His neurologic signs and symptoms may include confusion, drowsiness, stupor, and generalized tonic­clonic or focal seizures. Because the encephalopathy results from emergency hypertension, he also may exhibit signs of impaired cardiovascular and renal function, such as myocardial ischemia and a decreased glomerular filtration rate.

Retinal damage also can result from hypertensive encephalopathy. An ophthalmic examination may reveal retinal hemorrhages, exudates, and papilledema-a condition known as grade I.V. hypertensive retinopathy.