02336nas a2200397 4500000000100000008004100001260001600042653001100058653001100069653000900080653001400089653003000103653002000133653004200153653002700195653006600222653003300288653005600321653002700377653002100404653001600425653006700441653005200508653004300560653006000603653002200663100001900685700001500704700001600719245007100735250001500806300000800821490000700829520105100836020005101887 2014 d c30006730915 10 aFemale 10 aHumans 10 aMale 10 aPrognosis 10 aDrug Therapy, Combination 10 aRisk Assessment 10 aRandomized Controlled Trials as Topic 10 aInfusions, Intravenous 10 aAntihypertensive Agents/ administration & dosage/pharmacology 10 aBlood Pressure Determination 10 aCerebral Hemorrhage/complications/diagnosis/therapy 10 aCritical Care/ methods 10 aCritical Illness 10 aEmergencies 10 aHypertension/ drug therapy/etiology/ mortality/physiopathology 10 aNervous System Diseases/complications/diagnosis 10 aStroke/complications/diagnosis/therapy 10 aSubarachnoid Hemorrhage/complications/diagnosis/therapy 10 aSurvival Analysis 1 aAnderson Craig 1 aManning L. 1 aRobinson T. 00 aControl of blood pressure in hypertensive neurological emergencies a2014/04/29 a436 0 v16 3 a
Neurological hypertensive emergencies cause significant morbidity and mortality. Most occur in the setting of ischaemic stroke, spontaneous intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH), but other causes relate to hypertensive encephalopathy and reversible cerebral vasoconstriction syndrome (RCVS). Prompt and controlled reduction of blood pressure (BP) is necessary, although there remains uncertainty as to the optimal rate of decline and ideal antihypertensive agent. There is probably no single treatment strategy that covers all neurological hypertensive emergencies. Prompt diagnosis of the underlying disorder, recognition of its severity, and appropriate targeted treatment are required. Lack of comparative-effectiveness data leaves clinicians with limited evidence-based guidance in management, although significant developments have occurred recently in the field. In this article, we review the management of specific neurological hypertensive emergencies, with particular emphasis on recent evidence.
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