{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:26:02Z","timestamp":1787199962367,"version":"build-2736575974"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Pure autonomic failure (PAF) is characterized by neurogenic orthostatic hypotension and marked blood pressure (BP) lability. Droxidopa is widely used for symptomatic management and is generally well tolerated. We report a 60-year-old woman with advanced PAF who developed a hypertensive emergency with vasogenic cerebral edema shortly after initiation of low-dose droxidopa. This case highlights that severe hypertensive complications with reversible cerebral edema may occur even during low-dose droxidopa initiation in vulnerable patients with advanced autonomic dysfunction, underscoring the need for cautious dose titration and close BP monitoring.<\/jats:p>","DOI":"10.3389\/fneur.2026.1848250","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:16:03Z","timestamp":1787199363000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertensive emergency with vasogenic cerebral edema following droxidopa initiation in pure autonomic failure"],"prefix":"10.3389","volume":"17","author":[{"given":"Min-Ku","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurology, Kyung-il Neurology Medicine Center","place":["Daegu, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Sik","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Daegu Goodmorning Hospital","place":["Daegu, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Gyu","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yeungnam University College of Medicine","place":["Daegu, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1016\/j.mayocp.2019.03.009","article-title":"Pure autonomic failure","volume":"94","author":"Coon","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1016\/j.amjcard.2016.11.066","article-title":"Cardiovascular safety of droxidopa in patients with 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