UMEM Educational Pearls

A retrospective study analyzed data from 757 patients with spontaneous intraparenchymal hemorrhage.

Within the first 6 hours of admission, patients who had systolic blood pressure reduction between 40 – 60 mm Hg (OR 1.9, 95% CI 1.1-3.5) or reduction ≥ 60 mm Hg (OR 1.9, 95%CI 1.01-3.8) were associated with almost double likelihood of poor discharge functional outcome (defined as modified Rankin Scale 3-6).

Additionally, large systolic blood pressure reduction ≥ 60 mm Hg in patients with large hematoma (≥ 30.47 ml) was associated with higher likelihood of very poor functional outcome (mRS 5-6).

Take home points: while more studies are still needed to confirm these observations, perhaps we may not want to drop blood pressure in patients with spontaneous intraparenchymal hemorrhage too much and too fast.


The Magnitude of Blood Pressure Reduction Predicts Poor In-Hospital Outcome in Acute Intracerebral Hemorrhage.

Afshin A Divani, Xi Liu, Alexander Petersen, Simona Lattanzi, Craig S Anderson, Wendy Ziai, Michel T Torbey, Tom J Moullaali, Michael L James, Alibay Jafarli, Stephan A Mayer, Jose I Suarez, J Claude Hemphill, Mario Di Napoli.

Neurocrit Care.  2020 Oct;33(2):389-398. doi: 10.1007/s12028-020-01016-z.