Acute Arterial Hypertension in Patients undergoing Neurosurgery

• Main Authors: Nícollas Nunes Rabelo, Luciano José Silveira Filho, George Santos dos Passos, Luiz Antônio Araujo Dias Junior, Carlos Umberto Pereira, Luiz Antônio Araujo Dias, Eberval Gadelha Figueiredo
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2016-09-01
• Series: Brazilian Neurosurgery
• Subjects: postoperative period; arterial hypertension; neurosurgery; emergence hypertension
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1592412
• ISSN: 0103-5355; 2359-5922

Abstract Introduction Between 20–50% of neurosurgical patients may develop early perioperative complications, and ∼ 25% have more than one clinical complication. The most commons are high blood pressure (25%) and cardiovascular events (7%). Intraoperative hypertension is characterized by an increase of 20% in basal blood pressure. Objectives The aim of this paper is to review and discuss the pathophysiology, diagnosis and treatment of perioperative hypertension in patients undergoing neurosurgery, and to propose one table with therapeutic options. Methods A review using Scielo, PubMed, Ebsco and Artmed databases with inclusion and exclusion criteria. Articles published from 1957 to 2015 were selected. Discussion Five factors were established as causes: arterial hypertension, clinical conditions, surgical procedures, and operative and anesthetic factors. Specific causes preoperative, intraoperative and posoperative. The pathophysiology may have some relationship with catecholamines and sympathetic nervous system stimulation. Conclusion Perioperative hypertension in neurosurgery may have many causes, some of them recognizable and preventable. This increased pressure may be associated with intracranial hematomas in some cases. The recognition and treatment of this disease can be helpful in the management of the postoperative period.