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When Blood Pressure Needs Control After Stroke 

When Blood Pressure Needs Control After Stroke
Chapter:
When Blood Pressure Needs Control After Stroke
Source:
Neurocritical Care (2 ed.)
Author(s):

Eelco F. M. Wijdicks

, Alejandro A. Rabinstein

, Sara E. Hocker

, and Jennifer E. Fugate

DOI:
10.1093/med/9780190602659.003.0030

Blood pressure goals after acute ischemic and hemorrhagic stroke are commonly established early on. The rationale for treatment but also the uncertainties of when to treat are discussed in detail in this chapter. Treatment of hypertension in acute stroke patients depends on the type of stroke and the time from symptom onset. Patients with an ischemic stroke receiving thrombolysis need strict and consistent control of hypertension to avoid hemorrhagic complications. Patients with an ischemic stroke who are not candidates for endovascular recanalization should have their hypertension managed more conservatively. In patients with an intracerebral hemorrhage, moderate reduction of blood pressure is safe and may reduce the chances of hematoma expansion. In patients with aneurysmal subarachnoid hemorrhage, blood pressure should be reduced gradually during the first few hours.

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