Birendra Kumar Bista
NeuroCardio & Multispecialty Hospital, Nepal
Title: Blood pressure optimization in different types of stroke
Biography:
Dr BK Bista, is one of the first neurologists of Nepal. He has been pioneering in field of neuroscience in Nepal and established the first neuroscience center of eastern Nepal. Through years the work of this neuroscience center has been recognized home and abroad. He shows keen interest in medical management and providing state of art services to this impoverished region of Nepal. Recently he added the first stroke center of Nepal. He firmly believes in continuous updated education and its implementation in hospital practices.
Abstract:
Stroke alters the cerebral autoregulation as a result blood pressure is elevated in most of the stroke patients. Different stroke types namely, intracerebal hemorrhage, ischemic infarct and SAH (subarachnoid hemorrhage) each require different ranges of BP blood pressure optimization to maintain CPP and MAP. Inappropriate ranges of BP result as rebleed, infarct evolution and cerebral edema. The stroke types require different MAP(mean arterial pressure), CPP (cerebral perfusion pressure), systolic blood pressure (SBP) and diastolic blood pressure (DBP) to maintain adequate cerebral perfusion. Blood pressure optimization is among one of the most important steps in neuroprotection. This systemic review presents the latest updates in BP management in acute stroke. It also stipulates recommended ranges of CPP, MAP, ICP (Intracranial Pressure), SBP and DBP, for acute stroke management. Emphasis on, injectible antihypertensives only in acute stroke is given and commonly used IV (Intravenous) agents are also listed.