BloodPressureManagementinAcuteStrokeASNEN.pptVIP

* Alpha1-adrenergic blockers: Block the α1-receptors of vascular smooth muscle. Prevent uptake of catecholamines by the smooth muscle cells Nb Cerebral blood vessels: α1-stimulation - constriction Beta blockers: unclear mechanism of action: Inhibit renin release, Decrease noradrenaline release - ↓contractility of vascular smooth muscle. Produce peripheral vasodilation... * * * * * * Data analysed from the International Stroke Trial IST . * * * * * * * Can be enrolled into one or both arms * * * * * * * Prognostic indicators such as the volume of the bleed into the parenchymal tissue of the brain. It is well represented in the literature that this is the single most important predictor of outcome, prognosis, and deterioration potential. These will require close monitoring within a specialised unit. This is supported by the National Stroke Foundation Guidelines of the care of the stroke patient within a designated stroke unit. The care of the haemorrhagic stroke patient may also be appropriately managed within a share care scenario between the neurology team and the neurosurgeons; Usually age, comorbidities, location and severity of the bleed will influence the decision for the neurosurgeons to become involed Preexisiting disease within the small vessels also present a risk for more severe ICH * Higher propensity of Caucasian descent patients with ICH this is due to the………. When a young patient presents with a haemorrhage with very little known risk factors, AVM and illicit drug use should be considered and investigated as a potential cause * There are three phases within the development of the Intracerebral haemorrhage: Initial Haemotoma caused by the previously mentioned risk factors or unknown aetiology, As Liz has discussed most of these patients will present to the emergency department particularly unwell; extremely hypertensive- 180+ systolic, they maybe nauseated, decreased GCS, focal neurology and cranial nerve involvement dependant on location, seve