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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Haemodynamic effects during hypotension with sodium nitroprusside in the surgery of cerebral aneurysms were studied in 16 patients. Sodium Nitroprusside caused arterial hypotension by a direct vascular musculotropic effect and it was found to reduce peripheral vasculare resistance, and to lower the bloodpressure in the right atrium and pulmonary arteries. Stroke volume decreased in the presence of tachycardia while there was no change in cardiac output. Its evanescent action and easy regulation make sodium nitroprusside suitable for controlled hypotension during cerebral surgery, especially since there are no negative haemodynamic effects.
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PMID:[Haemodynamic effects during hypotension with sodium nitroprusside neurosurgery (author's transl)]. 101 50

Diastolic blood pressure of 120 mm Hg or more is often cited as identifying a hypertensive crisis. However, the absolute level of blood pressure may not be as important as the rate of increase. One important feature that distinguishes hypertensive emergency from hypertensive "urgency" is the ongoing vascular damage that occurs with hypertensive emergency. When this is present, therapy should be initiated as soon as possible. The initial goal is to reduce mean arterial pressure about 15% to 25% within the first 48 hours. Overzealous or uncontrolled reduction in blood pressure may result in coma, stroke, myocardial infarction, acute renal failure, or death. Thus, a drug with titratable dosing (eg, intravenous nitroprusside sodium [Nipride, Nitropress]) is preferred in most situations. Patients with hypertensive urgency do not have evidence of vascular damage. Usually, they are asymptomatic, have no retinal lesions, and have a marked elevation in diastolic blood pressure. Hypertensive urgency does not require immediate normalization of blood pressure, but initiation of therapy and careful follow-up are critical.
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PMID:Treating hypertensive emergencies. Controlled reduction of blood pressure and protection of target organs. 843 61