Hypertensive leukoencephalopathy refers to a degeneration of the white matter

White matter

White matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...

 of the brain following a sudden increase in blood pressure.

Presentation

Patients can present with sudden increase in blood pressure, acute confusional state, headaches, vomiting, and seizure. Retinal hemorrhages and hard exudates may be present on funduscopic exam. Hypertensive leukoencephalopathy may have concurrent cardiac ischemia and hematuria.

Imaging

MRI shows hyperintensities on T2 weighted imaging, localized usually to the parietal and occipital regions.