Adverse Effects of Aggressive Blood Pressure Control in Patients with Intracerebral Hemorrhage
Background Medical management of patients presenting with spontaneous intracerebral hemorrhage (ICH) is focused on blood pressure (BP) management. However, the BP goal to prevent ICH expansion remains controversial. Recent clinical trials have suggested that aggressive BP control is safe but may not...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Korean Neurocritical Care Society
2017-06-01
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| Series: | Journal of Neurocritical Care |
| Subjects: | |
| Online Access: | http://www.e-jnc.org/upload/pdf/jnc-160102.pdf |
| Summary: | Background Medical management of patients presenting with spontaneous intracerebral hemorrhage (ICH) is focused on blood pressure (BP) management. However, the BP goal to prevent ICH expansion remains controversial. Recent clinical trials have suggested that aggressive BP control is safe but may not have the previously thought benefits. Case Report We present an example of aggressive BP control in the setting of hypertensive ICH, in accordance to previously established protocols. This resulted in adverse effects in the form of acute kidney injury and watershed infarcts, which impeded the patients’ recovery and prolonged his hospitalization. Conclusions Hypertensive individuals have altered cerebral autoregulation curves shifted to the right and require higher arterial pressures to maintain adequate cerebral blood flow. Hence, aggressive BP reduction may result in cerebral hypoperfusion as well as other forms of end-organ damage. |
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| ISSN: | 2005-0348 2508-1349 |