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Blood Pressure Management After Central Nervous System Injury

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Textbook of Neurointensive Care

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Abstract

Uncontrolled hypertension is often encountered after brain injury. The mechanisms surrounding this physiopathological response are related to autoregulatory responses aimed at preserving the cerebral blood flow in injured areas. The initial hypertensive response may precipitate further injury. Conversely, aggressive blood pressure reduction may be associated with ischemia. Despite the clear role of blood pressure as a modulator of acute brain injury, there is considerable controversy and a lack of high-quality data regarding the demographics, outcomes, and optimal management of high blood pressure in acute brain-injured patients. Recognition of the autoregulatory abnormalities seen after brain injury and careful control of blood pressure are necessary for the optimal management of these patients.

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Authors and Affiliations

  1. Department of Neurosurgery, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA, 19107, USA

    Fred Rincon MD, MSc, MBE, FACP, FCCP, FCCM

  2. Department of Neurosciences, California Pacific Medical Center, 2100 Webster Street, #404, San Francisco, CA, 94115, USA

    Jack C. Rose MD

  3. Neurocritical Care Division, Columbia University Medical Center, 177 Fort Washington Ave, MHB Suite 8-300, New York, NY, 10032, USA

    Stephan A. Mayer MD, FCCM

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  1. Fred Rincon MD, MSc, MBE, FACP, FCCP, FCCM
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  2. Jack C. Rose MD
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  3. Stephan A. Mayer MD, FCCM
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Correspondence to Stephan A. Mayer MD, FCCM .

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Editors and Affiliations

  1. Pulmonary and Critical Care Medicine, Geisinger Health System, Danville, Pennsylvania, USA

    A Joseph Layon

  2. Departments of Anesthesiology & Surgery, University of Florida College of Medicine, Gainesville, Florida, USA

    Andrea Gabrielli

  3. Department of Neurosurgery, University of Florida, Gainesville, Florida, USA

    William A. Friedman

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Rincon, F., Rose, J.C., Mayer, S.A. (2013). Blood Pressure Management After Central Nervous System Injury. In: Layon, A., Gabrielli, A., Friedman, W. (eds) Textbook of Neurointensive Care. Springer, London. https://doi.org/10.1007/978-1-4471-5226-2_12

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