Blood pressure management in stroke patients

Kim, Seung Min; Woo, Ho Geol; Kim, Yeon Jeong; Kim, Bum Joon

doi:10.18700/jnc.200028

Cited by 13 publications

(17 citation statements)

References 59 publications

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“…In the presence of lethal HT after tPA infusion (especially parenchymal hemorrhage type 2), few data on blood pressure treatment are available, especially when compared with other types of HT. In tPA-related HT, healthcare providers should determine the target blood pressure and consider the severity of sICH, risk of bleeding enlargement, and risk of impending ischemia ( 96 ). Theoretically, with incomplete recanalization, higher blood pressure targets may be needed to maintain adequate collateral blood flow to the ischemic bed and reduce the risk of infarct growth among patients with HI-1 and HI-2 ( 97 ).…”

Section: Prevention Of Ht Expansionmentioning

confidence: 99%

“…High variability in blood pressure has been considered a strong risk factor for cerebral edema and post-stroke HT, as rapid changes in blood pressure can easily rupture already damaged blood vessels due to ischemic insult ( 100 , 101 ). Current guidelines recommend maintaining blood pressure below a fixed threshold of 180/105 mmHg for at least 24 h, regardless of thrombolytic or endovascular intervention ( 96 , 102 ). A recent US study reported that a peak systolic BP of 158 mmHg in the first 24 h after endovascular therapy best dichotomized good and bad outcomes ( 103 ).…”

Section: Blood Pressure Management After Thrombectomy For Preventing Htmentioning

confidence: 99%

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Hemorrhagic Transformation After Ischemic Stroke: Mechanisms and Management

Hong

Kim

2021

Front. Neurol.

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Symptomatic hemorrhagic transformation (HT) is one of the complications most likely to lead to death in patients with acute ischemic stroke. HT after acute ischemic stroke is diagnosed when certain areas of cerebral infarction appear as cerebral hemorrhage on radiological images. Its mechanisms are usually explained by disruption of the blood-brain barrier and reperfusion injury that causes leakage of peripheral blood cells. In ischemic infarction, HT may be a natural progression of acute ischemic stroke and can be facilitated or enhanced by reperfusion therapy. Therefore, to balance risks and benefits, HT occurrence in acute stroke settings is an important factor to be considered by physicians to determine whether recanalization therapy should be performed. This review aims to illustrate the pathophysiological mechanisms of HT, outline most HT-related factors after reperfusion therapy, and describe prevention strategies for the occurrence and enlargement of HT, such as blood pressure control. Finally, we propose a promising therapeutic approach based on biological research studies that would help clinicians treat such catastrophic complications.

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Section: Prevention Of Ht Expansionmentioning

confidence: 99%

Section: Blood Pressure Management After Thrombectomy For Preventing Htmentioning

confidence: 99%

Hemorrhagic Transformation After Ischemic Stroke: Mechanisms and Management

Hong

Kim

2021

Front. Neurol.

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“…The present systematic review reports on two forms of hemorrhagic acute brain injury: ICH and SAH. These events recognize different pathophysiological mechanisms: in ICH, the bleeding is into brain parenchyma, while SAH is bleeding into the subarachnoid space [ 49 ]. Furthermore, the ICH and SAH differs in epidemiological characteristics.…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability for Outcome Prediction in Intracerebral and Subarachnoid Hemorrhage: A Systematic Review

Marino

Badenes

Bilotta

2023

JCM

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This systematic review presents clinical evidence on the association of heart rate variability with outcome prediction in intracerebral and subarachnoid hemorrhages. The literature search led to the retrieval of 19 significant studies. Outcome prediction included functional outcome, cardiovascular complications, secondary brain injury, and mortality. Various aspects of heart rate recording and analysis, based on linear time and frequency domains and a non-linear entropy approach, are reviewed. Heart rate variability was consistently associated with poor functional outcome and mortality, while controversial results were found regarding the association between heart rate variability and secondary brain injury and cardiovascular complications.

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“…Tekanan darah tinggi menyebabkan peningkatan stres oksidatif, proses inflamasi, disfungsi endotel, pembentukan plak dalam pembuluh darah, dan progresifitas terhadap proses aterosklerosis yang mengarah pada terjadinya stroke iskemik. 10 Hasil penelitian ini menunjukkan bahwa mayoritas pasien dari kedua kelompok mengalami malnutrisi ringan-sedang berdasarkan rating PGS. Terdapat beberapa teori dan hasil penelitian yang menjelaskan mengenai bagaimana patogenesis terjadinya malnutrisi akibat stroke.…”

Section: Pembahasanunclassified

Perbandingan Status Nutrisi Pasien Stroke Iskemik Pertama dan Ulang di RSUP Dr. Hasan Sadikin Bandung

Khairunnisa

2023

JNI

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Background and Objective: Stroke has various clinical manifestations that can cause low nutritional intake. Stroke patients can also experience recurrent stroke. This study aims to determine the comparison of nutritional status in patients with first and recurrent ischemic stroke based on Body Mass Index (BMI) and Subjective Global Assessment (SGA). Subject and Methods: This study is a comparative analysis of the medical records of patients with first and recurrent ischemic stroke at RSUP Dr. Hasan Sadikin Bandung period 2018−2019. The sample selection method was carried out by consecutive sampling with 118 patients for each group. Data analysis for nominal data was tested by Fisher’s exact test, for ordinal and numerical data tested by Mann Whitney test. Result: A total of 236 subjects in both groups of first and recurrent ischemic stroke patients consisting of 130 men and 106 women with an average age of 56,64±14,60 and 61,75±11,36 years, and the majority had risk factors for hypertension. Based on BMI, the majority of ischemic stroke patients were categorized as normal and obese in the first (33,05%) and obese in recurrent ischemic stroke (37,39%), p>0,05. SGA B rating (64,41% in the first and 66,95% in the recurrent ischemic stroke), p>0,05. Conclusion: There was no statistically significant difference in the nutritional status of first and recurrent ischemic stroke patients based on SGA and BMI, but the proportion of recurrent ischemic stroke patients had worse nutritional status. The majority of ischemic stroke patients are obese, in contrast to the SGA which shows that patients are mildly-moderately malnourished

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Blood pressure management in stroke patients

Cited by 13 publications

References 59 publications

Hemorrhagic Transformation After Ischemic Stroke: Mechanisms and Management

Hemorrhagic Transformation After Ischemic Stroke: Mechanisms and Management

Heart Rate Variability for Outcome Prediction in Intracerebral and Subarachnoid Hemorrhage: A Systematic Review

Perbandingan Status Nutrisi Pasien Stroke Iskemik Pertama dan Ulang di RSUP Dr. Hasan Sadikin Bandung

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