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The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

Document Type : Review Article

Authors

1 Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran

2 Department of Neurosurgery, Division of Neuro Critical Care, University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, Texas, USA

3 Deccan College of Medical Sciences, Owaisi Hospital and Research Centre, Hyderabad, Telangana State, India

4 Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran

5 University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, Texas, USA

Abstract

Aneurysmal subarachnoid hemorrhage ‎(aSAH) ‎accounts for 2–5% of all strokes, and 10%‐15% of ‎aSAH patients will not survive until hospital admission. Induced hypertension (IH) is an emerging therapeutic option being used for the treatment of vasospasm in ‎aSAH. For patients with cerebral vasospasm (CVS) consequent to SAH, IH is implemented to increase systolic blood pressure (SBP) in order to optimize cerebral blood flow (CBF) and prevent delayed cerebral ischemia (DCI). Prophylactic use of IH has been associated with the development of vasospasm and cerebral ischemia in SAH patients. Various trials have defined several different parameters to help clinicians decide when to initiate IH in a SAH patient. However, there is insufficient evidence to recommend therapeutic IH in aSAH due to the possible serious complications like myocardial ischemia, development of posterior reversible encephalopathy syndrome (PRES), pulmonary edema, and even rupture of another unsecured aneurysm. This narrative review showed the favorable impact of IH therapy on aSAH patients; however, it is crucial to conduct further clinical and molecular experiments to shed more light on the effects of IH in aSAH.

Keywords

References
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Current Journal of Neurology
Volume 22, Issue 3
July 2023
Pages 188-196
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