For those with a systolic blood pressure greater than 180 mmHg, the goal for blood pressure management should be a systolic blood pressure of 160 mmHg. However, if the patient has increased intracranial pressure and a systolic blood pressure at least 180 mmHg, then the blood pressure should be lowered to reach a cerebral perfusion pressure 61 to 80 mmHg. One should be aware that some medications that lower systemic blood pressure can actually increase cerebral perfusion, which could further increase intracranial pressure. Teleanu and Constantinescu (2014) suggest using short acting alpha and beta blocking agents, such as labetalol, or vasodilators like hydralazine. Angiotensin-converting-enzyme inhibitors and calcium channel blockers are also appropriate choices for blood pressure management in this cohort. Venous vasodilators should not be used, for they will increase intracranial pressure. Increased intracranial pressures can be managed by elevating the head of bed to 30 degrees and intravenous sedatives and analgesics. If the patient has a Glasgow Coma Scale score of less than 8, have symptoms of herniation, large intraventricular
For those with a systolic blood pressure greater than 180 mmHg, the goal for blood pressure management should be a systolic blood pressure of 160 mmHg. However, if the patient has increased intracranial pressure and a systolic blood pressure at least 180 mmHg, then the blood pressure should be lowered to reach a cerebral perfusion pressure 61 to 80 mmHg. One should be aware that some medications that lower systemic blood pressure can actually increase cerebral perfusion, which could further increase intracranial pressure. Teleanu and Constantinescu (2014) suggest using short acting alpha and beta blocking agents, such as labetalol, or vasodilators like hydralazine. Angiotensin-converting-enzyme inhibitors and calcium channel blockers are also appropriate choices for blood pressure management in this cohort. Venous vasodilators should not be used, for they will increase intracranial pressure. Increased intracranial pressures can be managed by elevating the head of bed to 30 degrees and intravenous sedatives and analgesics. If the patient has a Glasgow Coma Scale score of less than 8, have symptoms of herniation, large intraventricular