J Med Life Sci > Volume 7(1); 2010 > Article
Journal of Medicine and Life Science 2010;7(1):174-177.
DOI: https://doi.org/10.22730/jmls.2010.7.1.174    Published online June 30, 2010.
치료 목적의 유발 고혈압을 통한 급성 허혈성 뇌경색 환자의 치료 :증례 보고
김중구, 이재영, 김지영, 강지훈, 강사윤, 이정석, 최재철
제주대학교 의학전문대학원 신경과학교실
Therapeutic induced blood pressure eJevation for the treatment of acute brain ischemia : Case report
Joong Goo Kim, Jae Young Lee, Jee Young Kim, Ji-Hoon Kang, Sa-Yoon Kang, Jung Seok Lee, Jay Chol Choi
Department of Neurology, Jeju National University School of Medicine, Jeju, Korea
Correspondence:  Jay Chol Choi, Email: iguazzu@hanmail.net
Abstract
Reperfusion of the ischemic brain is the most effective therapy for salvage of penumbral tissue in acute ischemic stroke. However, only a few patients are eligible for thrombolytic therapy due to time limit or other unavoidable contraindications for the treatment in spite of the presence of salvageable tissue. Several small clinical studies have shown that pharmacologically induced blood pressure elevation may improve neurological deficits in acute ischemic stroke, presumably by augmenting blood flow to penumbral brain tissue. We report a patient with acute ischemic stroke who showed successful recovery of neurologic deficit after therapeutic induced hypertension. A 69 years old man presented with acute ischemic stroke due to atherothrombotic occlusion of right internal carotid artery. Initial cranial MRI showed significant perfusion-diffusion mismatch. The patient showed progressive deterioration despite intravenous thrombolysis. Induced hypertension therapy with phenylephrine was started to increase cerebral blood flow to ischemic brain tissue. Affer elevation of blood pressure, the patient's condition recovered markedly. There was no complication associated with induced hypertension. Drug induced hypertension therapy can be helpful in selected patients with acute ischemic stroke who had perfusion-diffusion mismatch on MRI due to severe stenosis or occlusion of large cerebral arteries.
Key Words: Induced hypertension; Phenylephrine; Ischemic penumbra
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