A 44-year-old female presents with recurrent severe headaches and increasing visual problems. Physical examination reveals her blood pressure to be 200/140. Her symptoms are most likely to be associated with

Malignant hypeension refers to dramatic elevations in systolic and diastolic blood pressure often resulting in early death from cerebral and brainstem hemorrhages. Pathologically, the renal vessels demonstrate a concentric obliteration of aerioles by an increase in smooth-muscle cells, and protein deposition in a laminar configuration that includes fibrin material, which leads to total and subtotal occlusion of the vessels. These changes are called hyperplastic aeriolosclerosis. Medial calcific sclerosis (Monckeberg's aeriosclerosis) is characterized by dystrophic calcification in the tunica media of muscular aeries. There is no narrowing of the lumen of the affected vessels Hyaline aeriolosclerosis as seen in diabetes mellitus is presumably caused by leakage of plasma components across the endothelium Thromboangiitis obliterans (Buerger's disease) is occlusion by a proliferative inflammatory process in aeries of heavy cigarette smokers. Hyperplastic aeriosclerosis Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.