An unusual case of hypertensive encephalopathy

This case report describes a 59-year-old male who presented with headaches, seizures and hypertension followed by coma. Initial magnetic resonance imaging showed T2 hyperintensities typical of Hypertensive Encephalopathy (HE), the follow up scans showed diffusion-weighted imaging (DWI) hyperintensities which is a rare finding in HE. DWI hyperintensities are typically suggestive of areas of cytotoxic damage, and the presence of these changes makes this case unusual, since the pathogenesis of HE is usually due to vasogenic oedema rather than cytotoxic damage of the brain tissue.