高血压性视网膜病变合并可逆性后部脑病综合征1例报道 A Case Report of Hypertensive Retinopathy Combined with Posterior Reversible Encephalopathy Syndrome

Abstract

视网膜病变是高血压常见并发症之一，但同时合并可逆性后部脑病综合征少有报道。本文报道1例34岁男性患者，以视物模糊、头痛为主要表现，视力、眼压正常，双眼眼底检查显示火焰状视网膜出血和棉絮斑，诊断为高血压性视网膜病变。门诊测血压230/150 mmHg（1 mmHg=0.133 kPa），头颅MRI FLAIR序列示双侧大脑半球及脑干多发斑片状高信号。除肾损害外，血清学和脑脊液检查未见异常。积极予以降血压治疗后，患者临床症状和头颅影像学征象均改善，最终临床诊断为可逆性后部脑病综合征。 Abstract: Retinopathy is one of the common complications of hypertension, but the combination of posterior reversible encephalopathy syndrome (PRES) is rarely reported. This paper reported a 34-year-old male patient, presenting with blurred vision and headache as the main symptoms. The visual acuity and intraocular pressure were normal. Fundus examination of both eyes revealed flame-shaped retinal hemorrhage and cotton wool spots, leading to a diagnosis of hypertensive retinopathy. Blood pressure was 230/150 mmHg (1 mmHg=0.133 kPa) measured in the clinic, and cranial MRI FLAIR sequence showed multiple patchy hyperintensity in both cerebral hemispheres and brain stem. Aside from renal injury, serological and cerebrospinal fluid tests showed no abnormalities. After aggressive antihypertensive therapy, the clinical symptoms and cranial imaging signs of the patient were improved, and the final clinical diagnosis was PRES.

Keywords

• 高血压性视网膜病变
• 可逆性后部脑病综合征
• 降血压治疗
• hypertensive retinopathy
• posterior reversible encephalopathy syndrome
• antihypertensive therapy