Acute Blood Pressure Management in Neurocritically Ill Patients

Pharmacotherapy. 2019 Mar;39(3):335-345. doi: 10.1002/phar.2233. Epub 2019 Mar 11.


Optimal blood pressure (BP) management is controversial in neurocritically ill patients due to conflicting concerns of worsening ischemia with decreased BP versus cerebral edema and increased intracranial pressure with elevated BP. In addition, high-quality evidence is lacking regarding optimal BP goals in patients with most of these conditions. This review summarizes guideline recommendations and examines the literature for BP management in patients with ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, traumatic brain injury, and spinal cord injury.

Keywords: blood pressure; neurocritical care; stroke.

Publication types

  • Review

MeSH terms

  • Blood Pressure / physiology*
  • Brain Edema / therapy
  • Brain Ischemia / therapy
  • Critical Illness
  • Humans
  • Hypertension / complications
  • Hypertension / therapy*
  • Hypotension / complications
  • Hypotension / therapy*
  • Intracranial Hypertension / therapy
  • Nervous System Diseases / physiopathology
  • Nervous System Diseases / therapy