10.3.2 Headache attributed to hypertensive crisis without hypertensive encephalopathy

Identification: A 58-year-old male patient with a history of poorly controlled systemic arterial hypertension (SAH) reports irregular adherence to antihypertensive medication. Chief complaint: Intense, bifrontal, pulsatile headache lasting 4 hours, associated with blurred vision and general malaise. Physical examination: Blood pressure: 210/120 mmHg (confirmed in both arms). Neurological examination: No focal deficits, no signs of meningeal irritation, and fundoscopic examination without papilledema or hemorrhages. The remainder of the physical examination showed no relevant alterations. Complementary exams: Cranial CT scan showed no alterations. Laboratory tests (electrolytes, urea, creatinine) were within normal limits.