Question

A 70-year-old woman presents to the emergency department with severe headache, confusion and visual disturbance. Her blood pressure is 230/130 mmHg with papilloedema and focal neurological signs. There is no history of trauma. What is the most appropriate immediate management strategy?

Accepted Answer

Controlled reduction of BP with intravenous antihypertensive infusion in a high-dependency setting

Answer

Discharge with oral antihypertensives and review in 48 hours

Answer

Rapid reduction of BP to normal within 30 minutes using sublingual nifedipine

Answer

No active BP lowering to avoid cerebral hypoperfusion

Answer

Single dose of oral clonidine and observation in the ED

Practice question

A 70-year-old woman presents to the emergency department with severe headache, confusion and visual disturbance. Her blood pressure is 230/130 mmHg with papilloedema and focal neurological signs. There is no history of trauma. What is the most appropriate immediate management strategy?