In the year 1928, two important concepts were introduced in the study of hypertension. Keith et al used the term “malignant hypertension” in severely hypertensive patients with papilledema, retinal hemorrhages, and exudates whose prognoses were worse than those with less retinopathy. Oppenheimer and Fishberg introduced the term “hypertensive encephalopathy” when they described a syndrome of transient neurological disturbances with seizures, aphasia, confusion, headache, visual loss, and hemiplegia in a 19-year-old patient with severe hypertension. Episodes of transient neurologic dysfunction with reversible aphasia, hemiparesis, and other focal neurological signs during the period of sudden rise in the systemic blood pressure had been described previously. Yet it was not until Oppenheimer and Fishberg who categorized these disturbances as hypertensive encephalopathy [HE] , that it became an acceptable entity