Postoperative hypertension in the management of patients with intracranial arterial aneurysms

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✓ Elevation of systemic arterial pressure in seven patients with intracranial arterial aneurysms has been shown to be effective in alleviating ischemic symptoms attributed to cerebral vasospasm. Autoregulation is at least partially lost in patients with cerebral hemodynamic crisis. Blood volume expansion was used to augment vasopressors in maintenance of systemic hypertension. The management of these cases is discussed. Caution in the use of this technique is advised, since the regimen is not without risk.

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Address reprint requests to: Edward J. Kosnik, M.D., Division of Neurological Surgery, University Hospital, Columbus, Ohio 43210.

© AANS, except where prohibited by US copyright law.

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    Postoperative course in Case 1, showing the patient's blood pressure, central venous pressure, and neurological status. Note the improvement occurring with pressure elevation.

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    Postoperative course in Case 3. This patient had two changes in his neurological status, both of which were resolved with pressure elevation.

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