Question

A 58-year-old man with long-standing poorly controlled hypertension presents with sudden severe occipital headache, vomiting and ataxia. CT brain shows cerebellar haemorrhage. Blood pressure is 210/110 mmHg. What is the most important initial blood pressure management principle?

Accepted Answer

Lower systolic blood pressure to around 140 mmHg using intravenous agents while avoiding rapid overcorrection

Answer

Leave blood pressure untreated to maintain cerebral perfusion

Answer

Rapidly lower blood pressure to systolic <100 mmHg

Answer

Aim to normalise blood pressure to 120/80 mmHg within the first hour

Answer

Start oral antihypertensives only and review in 24 hours

Practice question

A 58-year-old man with long-standing poorly controlled hypertension presents with sudden severe occipital headache, vomiting and ataxia. CT brain shows cerebellar haemorrhage. Blood pressure is 210/110 mmHg. What is the most important initial blood pressure management principle?