Acute Care Neurosurgery by Case Management by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030995126
Publisher: Springer International Publishing

14.4.3 Blood Pressure Control

Systolic blood pressure control should be initiated immediately in the ED to prevent hematoma expansion. Studies have shown no significant reduction in cerebral blood flow within the perihematomal area related to early intensive lowering of SBP to <140 mmHg within several hours of ICH onset. However, intensive BP lowering to <140 mmHg versus standard management to a target of <180 mmHg has not shown definitive outcome benefit and may increase rate of adverse renal events [22]. It is, nonetheless, reasonable to lower SBP to a target of <140 mmHg in patients presenting with SBP between 150 and 220 mmHg, with goals to stabilize the hematoma and to improve functional recovery in survivors [4, 23]. Speed and degree of BP reduction vary depending on the agent and mode of delivery; commonly used agents include intravenous hydralazine, labetalol, and nicardipine infusion.

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