Two important clinical features complicate the management of hypertension in acute stroke. First, during acute stroke, cerebral autoregulation may be compromised, and lowering of blood pressure may compromise cerebral blood flow further and extend ischemic injury. Second, medications used to treat hypertension may lead to cerebral vasodilation, resulting in increased cerebral blood flow and progression of cerebral edema. Ideally a correct level of mean arterial pressure should be maintained in each patient to maintain cerebral perfusion pressure without risking worsening cerebral edema or progression of the lesion, but the clinical determination of this ideal value is difficult. TEXTBOOK OF CRITICAL CARE(Fink)
Posted on: Thu, 16 Jan 2014 07:52:20 +0000
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