The Spectrum of Cerebral Vasoconstriction: A Diagnostic Conundrum

Submit Manuscript | http://medcraveonline.com J Neurol Stroke 2016, 4(1): 00119 It is well recognized that treatment of hypertension is critical in the early management of ICH, aneurysmal SAH, and RPLS. This creates a dilemma in that aggressive hypertension management can place a patient at risk of ischemia due to cerebral hypoperfusion. There is no specific blood pressure control and CV management guidelines in RCVS, which creates the challenge of treating patients with RCVS who also suffer from delayed ischemic infarcts from CV. It is important to note that CV in RCVS is expected to last up to 12 weeks [1], whereas CV in aneurysmal SAH is known to last up to four weeks [3]. In aneurysmal SAH, there is a clear guideline that emphasizes the importance of calcium channel blocker (CCB) treatment with the “Triple-H” therapy of hypertension, hypervolemia, and hemodilution to treat active vasospasms and prevent delayed cerebral ischemia [4].