2024 AANS Neurosurgical Topics for APPs - On-Demand-Management of Hypertensive Crisis- Elisabeth Webb

Video Transcription

Video Summary

In the lecture, Elizabeth Webb, a clinical coordinator at the Shepherd Center in Atlanta, discusses the management of hypertensive crises with a focus on medication strategies and blood pressure recommendations during intracerebral hemorrhage and acute ischemic stroke. Hypertensive crises are categorized as urgencies (high blood pressure without organ damage) or emergencies (high blood pressure with organ damage). Urgencies can usually be managed with oral medications, while emergencies require ICU management and intravenous medications.<br /><br />Risk factors for hypertension include age, sex, race, and lifestyle choices. Management strategies involve lifestyle modifications and pharmacotherapy using calcium channel blockers, ACE inhibitors, and potentially beta blockers. For hypertensive emergencies, the immediate goal is a 25% reduction in systolic blood pressure within the first hour.<br /><br />The lecture also covers hypertensive crises specific to patients with spinal cord and brain injuries, including autonomic dysreflexia and paroxysmal sympathetic hyperactivity. Webb emphasizes the importance of choosing appropriate medications based on comorbidities and transitioning care to oral therapy when stable. The session concludes with guidelines for selecting drugs based on patient needs and conditions.

Keywords

hypertensive crises

intracerebral hemorrhage

acute ischemic stroke

medication strategies

autonomic dysreflexia

paroxysmal sympathetic hyperactivity

blood pressure management