Is emergent anti-hypertensive treatment beneficial in intracranial hemorrhage?

Burke, Rachel; Dorfman, M.; Chan, S.B.

doi:10.1016/j.jemermed.2005.01.003

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…It is more likely to be related to their larger hematoma volumes, higher rates of intraventricular extension, and lower GCS scores than the survivors, as these are the most important predictors of mortality from ICH (21). The observed mortality of 41%, with most deaths occurring the first 2 days, is consistent with prior studies (1,2,6,18,19,22). The 24-h median proportional hematoma growth in patients that survived was 4.5%.…”

Section: Discussionsupporting

confidence: 89%

“…A retrospective chart review by Burke et al found that patients with spontaneous ICH treated with antihypertensives in the first 6 h from initial presentation had a significant reduction in mortality compared to patients not treated in this time frame (18). A study by Qureshi et al observed that patients with spontaneous ICH treated within 6 h of symptom onset were more likely to be functionally independent as judged by the mRS, compared to patients who were treated between 6 and 24 h (19).…”

Section: Discussionmentioning

confidence: 99%

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Emergency Department Control of Blood Pressure in Intracerebral Hemorrhage

Honner

Singh

Cheung

et al. 2011

The Journal of Emergency Medicine

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Emergency Department Control of Blood Pressure in Intracerebral Hemorrhage

Honner

Singh

Cheung

et al. 2011

The Journal of Emergency Medicine

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“…34 This was complemented by several studies that showed that early treatment of elevated BP was associated with a decrease in mortality and poor outcome. [35][36][37][38][39][40] On the contrary, Qureshi 41 showed that a rapid decline in BP within 24 hours from ICH onset was associated with a rise in mortality.…”

Section: Evidence From Observational and Pilot Studiesmentioning

confidence: 99%

Blood Pressure Management in Intracerebral Hemorrhage

Mohammad

Qureshi

2016

Semin Neurol

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Intracerebral hemorrhage (ICH) is associated with devastating outcomes. Admission to the intensive care unit has been the only proven course to improve outcomes. All other treatment modalities have failed so far. The majority of patients presenting with ICH have an elevated blood pressure (BP). Initial data on the safety and efficacy of BP treatment in acute ICH have been conflicting. This has led to large prospective and randomized clinical trials to assess the safety and efficacy of early BP lowering in acute ICH. These trials showed safety and a tendency toward improved functional outcomes. In fact, the results of three subsequent meta-analyses also showed safety and possible efficacy of early lowering of BP in ICH. Based on the results of the published clinical trials and meta-analyses, the American Heart Association and the European Stroke Association concluded that early intensive treatment of BP in acute ICH is safe and might improve functional outcome. The authors advocate that-pending additional data from ongoing trials-health care professionals should maintain the SBp < 140 mm Hg in patients presenting with acute ICH.

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“…37% for subarachnoid hemorrhage (SAH) (10,30,33), 30% to 76% for intracerebral hemorrhage (ICH) (4,15,19), 46% to 74% for subdural hemorrhage (8,9,11,26), and 5% to 25% for epidural hemorrhage (8,23,25). Mortality rate is a good measure of outcome, but it is also important to study the quality of life after treatment.…”

mentioning

confidence: 99%