Question

A 53-year-old man with poorly controlled hypertension develops sudden severe "worst-ever" headache and collapses. CT head confirms subarachnoid haemorrhage from a ruptured aneurysm. What is the most appropriate immediate blood pressure management strategy before neurosurgical intervention?

Accepted Answer

Control systolic BP to around 140 mm Hg with IV agents while avoiding hypotension

Answer

Allow BP to rise uncontrolled to maintain cerebral perfusion

Answer

Rapidly lower systolic BP to <100 mm Hg with IV nitroprusside

Answer

Start high-dose oral antihypertensives and delay IV therapy

Answer

Deliberately induce hypertension with vasopressors

Practice question

A 53-year-old man with poorly controlled hypertension develops sudden severe "worst-ever" headache and collapses. CT head confirms subarachnoid haemorrhage from a ruptured aneurysm. What is the most appropriate immediate blood pressure management strategy before neurosurgical intervention?