From the Research
For patients with a subdural hematoma, ideal blood pressure management typically aims for a systolic blood pressure below 140 mmHg to optimize healing and minimize the risk of rebleeding or hematoma expansion, as supported by the most recent study 1. The goal of blood pressure management in these cases is to balance the need to maintain adequate cerebral perfusion while reducing the risk of hematoma expansion.
- Medications commonly used for blood pressure management in these cases include labetalol, nicardipine, or clevidipine, with oral options for longer-term management including beta-blockers, calcium channel blockers, or ACE inhibitors.
- Blood pressure should be monitored frequently, typically every 1-2 hours in the acute setting, with continuous arterial monitoring for unstable patients, as suggested by the management guidelines for subdural hematomas 2.
- The choice of antihypertensive agent should be based on the individual patient's needs and medical history, with consideration of the potential effects on intracranial pressure, as studied in 3 and 4.
- Overall, careful blood pressure control is essential to prevent secondary injury and promote healing and neurological recovery in patients with subdural hematoma, as emphasized in the neurocritical care of acute subdural hemorrhage 5.