What is the focus of the initial treatment for hypertensive encephalopathy?

Updated: Dec 10, 2018
  • Author: Irawan Susanto, MD, FACP; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

In patients without hypertension, cerebral autoregulation preserves a relatively constant cerebral blood flow (CBF) at a mean arterial pressure (MAP) range of 60-90 mm Hg. In chronically hypertensive patients, autoregulation is altered and shifted upward to maintain a relatively constant CBF at a higher MAP range.

When therapy is initiated, it is important to consider the baseline blood pressure in order to avoid excessive blood pressure reduction and prevent cerebral ischemia. It is usually safe to reduce MAP by 25% and to lower the diastolic blood pressure to 100-110 mm Hg.


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