1. Hypertensive Emergency

  1. Edward M. Manno MD, FCCM, FAAN, FAHA
  1. Laurie McWilliams MD

Published Online: 11 APR 2012

DOI: 10.1002/9781118297162.ch1

Emergency Management in Neurocritical Care

Emergency Management in Neurocritical Care

How to Cite

McWilliams, L. (2012) Hypertensive Emergency, in Emergency Management in Neurocritical Care (ed E. M. Manno), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118297162.ch1

Editor Information

  1. Neurological Intensive Care Unit Cleveland Clinic Cleveland, OH, USA

Author Information

  1. Neurocritical Care Unit, Cerebrovascular Center, Department of Neurology and Neurosurgery, Cleveland clinic, Cleveland, OH, USA

Publication History

  1. Published Online: 11 APR 2012
  2. Published Print: 11 MAY 2012

Book Series:

  1. Neurology in Practice

Book Series Editors:

  1. Robert A. Gross and
  2. Jonathan W. Mink

Series Editor Information

  1. Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

ISBN Information

Print ISBN: 9780470654736

Online ISBN: 9781118297162



  • acute management of neurological emergencies;
  • hypertensive emergency, underlying neurologic disease;
  • hypertension and neurologic disease, coexisting;
  • blood pressure and aneurysmal SAH;
  • life-threatening end-organ damage;
  • acute ischemic stroke;
  • cerebral autogregulation;
  • vessel caliber changes, myogenic and metabolic;
  • EEG, in monitoring seizures;
  • beta blockers with brain dysfunction


Hypertension and neurologic diseases have an intricate relationship. In the cerebrovascular diseases, many of them are caused by long-standing hypertension, however, in the acute period, the brain demands elevated blood pressures to maintain its functioning. In some inflammatory disorders of the brain, an abrupt increase in blood pressures can cause significant damage to the brain, however, as in cerebrovascular diseases, careful lowering of blood pressures is required to allow the brain to maintain a status quo in the acute period. This chapter will enlighten the reader on the pathophysiology of blood pressure and cerebral blood flow – the basics for understanding how to manage blood pressure in neurologic emergencies. A brief discussion on antihypertensive agents will follow, with the remaining chapter discussing blood pressure management tailored to common neurologic diseases presenting with hypertensive crises.