Hypoperfusion and Its Augmentation in Patients with Brain Ischemia

Current Treatment Options in Cardiovascular Medicine
Robert J Wityk, Lucas Restrepo

Abstract

Control of hypertension is a well-established goal of the primary and secondary prevention of stroke. However, management of blood pressure in the setting of acute brain ischemia is complicated by the possible effect of blood pressure changes on cerebral perfusion. In acute stroke, patients may have an ischemic penumbra of brain tissue, which has impaired perfusion but which is not irreversibly damaged. The ischemic penumbra may be salvaged with reperfusion. Lowering of blood pressure in this setting, however, would hasten the progression of the penumbra to infarction. With the exception of patients treated with thrombolytic agents, blood pressure reduction is not recommended in acute ischemic stroke for this reason. Preliminary studies suggest that there may be a role for interventions to elevate blood pressure as a treatment for acute stroke patients. Despite interest in induced hypertension as a treatment of stroke dating back to the 1950s, this practice has not achieved widespread use owing to concerns about potential adverse effects such as intracerebral hemorrhage, cerebral edema, and myocardial ischemia. It is commonly used, however, to treat patients with threatened cerebral ischemia due to vasospasm after subarachnoid ...Continue Reading

References

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Citations

Jun 19, 2008·AACN Advanced Critical Care·Anne W Wojner Alexandrov
Sep 24, 2011·Lancet Neurology·Ashfaq ShuaibDavid S Liebeskind
May 6, 2008·Journal of the Neurological Sciences·Brian SilverMichael Chopp
Oct 8, 2021·European Journal of Applied Physiology·Hironori WatanabeShigehiko Ogoh

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Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

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Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

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