Hypertensive Encephalopathy

Confusion + severe HTN

Red flags
  • Papilloedema, retinal haemorrhage
  • Seizure, coma
  • Focal neuro deficit

First steps

  • ABCDE + arterial line
  • GCS, neuro exam
  • CT brain (exclude stroke/haemorrhage)

Key investigations

  • CT/MRI brain
  • U&E, urinalysis (haematuria, proteinuria)
  • ECG, troponin

Differentials

  • Ischaemic stroke
  • ICH/SAH
  • PRES
  • Toxic/metabolic encephalopathy

Initial management

  • Labetalol IV or nicardipine infusion
  • Target MAP reduction 10-20% first hour
  • Anticonvulsant if seizures (benzo → keppra/phenytoin)
  • Admit ICU

Referral

  • ICU + neurology
AI clinical assessment

Enter patient details to generate evidence-based guidance.

This tool is for educational and clinical support only. It does not replace professional medical judgment or institutional protocols.

WardRound

WardRound

Clinical Decisions in Seconds