This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (68)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Treat

J. David Spence, MD, FRCP(C); Rolando F. Del Maestro, MD, PhD, FRCS(C)

Arch Neurol. 1985;42(10):1000-1002.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The problem of a patient presenting to an emergency room with severe hypertension and a central nervous system (CNS) deficit is a common, dangerous, and vexing one. The received wisdom for many years has been: "in a patient with stroke, one must not treat the blood pressure, for fear of making the stroke worse." Indeed, examples abound of the disastrous consequences of aggressive treatment of severe hypertension. Even in patients presenting without any initial focal neurologic deficit, abrupt lowering of blood pressure may produce collapse, seizures, focal CNS deficits, and optic neuropathy, which have been assumed to be ischemic.^1-3

Presumably, advocates of the hands-off policy believe that abrupt lowering of blood pressure is dangerous because sudden reduction of cerebral perfusion pressure may render ischemic those parts of the brain whose blood supply is borderline because of arterial disease (eg, carotid occlusion) or areas of brain in which blood supply . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Medicine, Pharmacology, and Clinical Neurological Sciences, University of Western Ontario, London.

Footnotes
Accepted for publication Feb 5, 1985.

Reprint requests to Department of Medicine, Victoria Hospital, London, Ontario, Canada N6A 4G5 (Dr Spence).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?