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a 68-year-old man is brought to ER because of 5-hour history of weakness of the left extremities. physical exam show left hemiplegia with hemi-sensory loss. his blood pressure is 190/110. CT scan of the head reveals no blood, but a locus of brain swelling in the right hemisphere is present. his past medical history is hypertension and DM. best next step?
a. hypotensive agents are not indicated
b.administer manitol
c.iv nitroprusside
d. consider t-pa
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SORRY...b! not D. typing error.
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i think, minimal swelling will always be there when there is stroke and no one gives mannitol as the next step....i think...my analysis...
and in case of stroke...its not good to reduce the BP because reducing BP will lead to brain hemorrhage..we should maintain a little high bp to keep cerebral perfusion intact
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the ans is A
hypertension during an acute ischemic stroke should not be treated unless it is very severe(systolic blood pressure>22ommHg, diastolic blood pressure >120mmHg)or cause end-organ(pulmonary edema, unstable angina)
more than 3 hours, thrombolytic agent is not indicated.
