Hypertensive encephalopathy of brain stem with minimal supratentorial involvement: a rare manifestation of hypertensive encephalopathy.

We report a case of a 38-year-old man with brain stem hypertensive encephalopathy. MR imaging revealed diffuse hyperintensities in the brain stem. Diffusion-weighted imaging (DWI) was normal, and apparent diffusion coefficient (ADC) values were increased in the brain stem. The supratentorial regions were largely spared, and only subtle high intensities were seen. The lesions completely resolved after stabilization of blood pressure. The findings of normal DWI and high ADC values were compatible with vasogenic edema due to hypertension.