CT diagnosis of hypertensive brainstem encephalopathy (HBE): A diagnostic challenge in the emergency department

Hypertensive encephalopathy usually involves the posterior supratentorium, with uncommon involvement of the brainstem. We present a case of acute hypertensive encephalopathy of the brainstem diagnosed by means of CT. The brainstem was markedly hypodense, with no evidence of typical concomitant parieto-occipital involvement. The patient's symptoms and imaging findings improved after hypertension had been controlled.