Acute hypertension after stroke

Relationship of Blood Pressure, Antihypertensive Therapy, and Outcome in Ischemic Stroke Treated With Intravenous Thrombolysis

“…In hypertensive patients, cerebral autoregulation is potentially shifted to a higher level, 5 whereas in the ischemic penumbra, cerebral autoregulation is disrupted and cerebral perfusion pressure is directly related to systemic BP. 6 There is fear of reducing cerebral perfusion pressure, which is critical for cerebral blood flow in the penumbral zone, 7 in particular in light of adverse effects of BP-lowering using nimodipine in the acute phase of stroke. 8 -10 There are several unanswered questions about the management of hypertension during the acute phase of stroke: Should ongoing antihypertensive therapy be continued?…”

Aortic dissection presenting as concomitant stroke and STEMI

“…In the midst of a simple hemiplegic stroke (either thrombotic or haemorrhagic), one might have expected to observe a compensatory elevation in blood pressures to maintain cerebral perfusion, perhaps even profoundly so, rather than the decreased pressures that were recorded. 6 Further, the chest pain of a strict aortic dissection must always be kept on the differential diagnosis of acute myocardial infarction (MI). While the symptoms can be identical, the treatment for each is vastly different, if mutually exclusive.…”

Stroke pathophysiology: management challenges and new treatment advances

“…Systemic hypertension in the acute phase of ischemic stroke is common and is believed to be a physiologic response that attempts to maintain an adequate cerebral perfusion pressure within the ischemic penumbra (59). While appropriate in primary and secondary stroke prevention, the lowering of elevated blood pressure (BP) in the acute setting of ischemic stroke has been a matter of debate for several years.…”