Treatment:- Target mean arterial pressure of less than 110 mmHg or a blood pressure of less than 160/90 mmHg (1).
- In patients with spontaneous intracerebral hemorrhage, intensive lowering of blood pressure (<140 mmHg) did not result in a significant reduction in the rate of the primary outcome of death or severe disability. An ordinal analysis of modified Rankin scores indicated improved functional outcomes with intensive lowering of blood pressure (2,3).
- Patients with elevated intracranial pressure may require a higher mean arterial pressure to maintain target cerebral perfusion pressure. In such a population, multimodality monitoring may guide individualized blood-pressure goals (2).
References: - Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41:2108-2129: full text | pdf.
- Blood Pressure in Intracerebral Hemorrhage - How Low Should We Go? NEJM. May 29, 2013: full text | pdf.
- Rapid Blood-Pressure Lowering in Patients with Acute Intracerebral Hemorrhage. NEJM. May 29, 2013: full text | pdf.
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