Commentary: Posterior Reversible Encephalopathy Syndrome as a Complication of Induced Hypertension in Subarachnoid Hemorrhage: A Case-Control Study

Dépret, François; Coutrot, Maxime

doi:10.1093/neuros/nyy244

Cited by 2 publications

(5 citation statements)

References 12 publications

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“…An emerging potential complication that has only recently begun receiving attention is PRES. 54 The most widely discussed hypothesis explaining the cause of PRES is that severe hypertension may interrupt normal cerebral autoregulation. Once cerebral autoregulation fails, uncontrolled intracranial hypertension could lead to cerebral vessel damage, resulting in vasogenic edema.…”

Section: Introductionmentioning

confidence: 99%

“…Depret and Coutrot found that raising the mean arterial pressure (MAP) by approximately 30% led to PRES patients attaining much higher MAPs that could exceed the limits of autoregulation. 54 They suggested that clinicians consider the wide-ranging effects of BP elevation including the degree of spontaneous hypertension when selecting IH goals. In this study, attempting to raise patients’ MAP more than 50 mm Hg above their normal levels (or to absolute levels above 130-140 mm Hg) appeared to be associated with the development of PRES with high sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

“…In this study, attempting to raise patients’ MAP more than 50 mm Hg above their normal levels (or to absolute levels above 130-140 mm Hg) appeared to be associated with the development of PRES with high sensitivity and specificity. 54 Such aggressive IH may be reserved for refractory cases of DCI, and patients should be closely examined for neurological changes suggestive of PRES. PRES appears to be a relatively common complication of more aggressive IH therapy and should be suspected in any patient with unexplained neurological deterioration.…”

Section: Introductionmentioning

confidence: 99%

“…Alternative interventions may be preferred for refractory DCI when IH to these levels has already been attempted or in patients that are already spontaneously hypertensive. 54 , 57 …”

Section: Introductionmentioning

confidence: 99%

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The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

Azari Jafari,

Mirmoeeni,

Johnson

et al. 2023

CJN

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Aneurysmal subarachnoid hemorrhage ‎(aSAH) ‎accounts for 2-5% of all strokes, and 10%‐15% of ‎aSAH patients will not survive until hospital admission. Induced hypertension (IH) is an emerging therapeutic option being used for the treatment of vasospasm in ‎aSAH. For patients with cerebral vasospasm (CVS) consequent to SAH, IH is implemented to increase systolic blood pressure (SBP) in order to optimize cerebral blood flow (CBF) and prevent delayed cerebral ischemia (DCI). Prophylactic use of IH has been associated with the development of vasospasm and cerebral ischemia in SAH patients. Various trials have defined several different parameters to help clinicians decide when to initiate IH in a SAH patient. However, there is insufficient evidence to recommend therapeutic IH in aSAH due to the possible serious complications like myocardial ischemia, development of posterior reversible encephalopathy syndrome (PRES), pulmonary edema, and even rupture of another unsecured aneurysm. This narrative review showed the favorable impact of IH therapy on aSAH patients; however, it is crucial to conduct further clinical and molecular experiments to shed more light on the effects of IH in aSAH.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Alternative interventions may be preferred for refractory DCI when IH to these levels has already been attempted or in patients that are already spontaneously hypertensive. 54 , 57 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

Azari Jafari,

Mirmoeeni,

Johnson

et al. 2023

CJN

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“…When deciding to install the treatment, careful monitoring for cerebral and systemic adverse events seems equally important as careful instalment of the therapy. 176 Further, we suggest adjustment of recommendations in guidelines where induced hypertension is still recommended as Class I evidence. 70,177…”

Section: Complications Of Induced Hypertensionmentioning

confidence: 99%

Strategies for prevention and treatment of delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage

Gathier¹

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any means, electronic or mechanical, including photocopying, recording or any information storage or retrieval system, without prior permission in writing from the author. The copyright of articles that have been published or accepted for publication has been transferred TABLE OF CONTENTS PART I INTRODUCTION Chapter 1 General introduction PART II FACTORS ASSOCIATED WITH THE DEVELOPMENT OF DCI Chapter 2 Association of automatically quantified total blood volume with delayed cerebral ischaemia Chapter 3 Blood pressure and the risk of delayed cerebral ischaemia and rebleeding Chapter 4 Association of preventive antibiotics with delayed cerebral ischaemia PART III INDUCED HYPERTENSION FOR TREATMENT OF DCI Chapter 5 HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA): a randomised single-blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischaemia after subarachnoid haemorrhage Chapter 6 Effects of induced hypertension on cerebral perfusion in delayed cerebral ischaemia Chapter 7 Effects of induced hypertension on functional outcome in delayed cerebral ischaemia Chapter 8 Slow recruitment in the HIMALAIA Study: lessons for future clinical trials in patients with delayed cerebral ischaemia PART IV GENERAL DISCUSSION Chapter 9 General discussion and future directions

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Commentary: Posterior Reversible Encephalopathy Syndrome as a Complication of Induced Hypertension in Subarachnoid Hemorrhage: A Case-Control Study

Cited by 2 publications

References 12 publications

The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

Strategies for prevention and treatment of delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage

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