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Semin Neurol 2016; 36(03): 269-273
DOI: 10.1055/s-0036-1583264
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Blood Pressure Management in Intracerebral Hemorrhage

Yousef Mohammad
1   Division of Neurology, Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia
,
Adnan Qureshi
2   Department of Neurology, University of Minnesota, Minneapolis, Minnesota
› Author Affiliations
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Publication History

Publication Date:
23 May 2016 (online)

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Abstract

Intracerebral hemorrhage (ICH) is associated with devastating outcomes. Admission to the intensive care unit has been the only proven course to improve outcomes. All other treatment modalities have failed so far. The majority of patients presenting with ICH have an elevated blood pressure (BP). Initial data on the safety and efficacy of BP treatment in acute ICH have been conflicting. This has led to large prospective and randomized clinical trials to assess the safety and efficacy of early BP lowering in acute ICH. These trials showed safety and a tendency toward improved functional outcomes. In fact, the results of three subsequent meta-analyses also showed safety and possible efficacy of early lowering of BP in ICH. Based on the results of the published clinical trials and meta-analyses, the American Heart Association and the European Stroke Association concluded that early intensive treatment of BP in acute ICH is safe and might improve functional outcome. The authors advocate that—pending additional data from ongoing trials—health care professionals should maintain the SBp < 140 mm Hg in patients presenting with acute ICH.

Keywords

intracerebral hemorrhage - blood pressure - hematoma - cerebral blood flow