Trends in blood pressure: following subarachnoid haemorrhage and preceding cerebral vasospasm

Ali Abdulghani Binabdi

doi:10.33178/SMJ.2021.1.5

Authors

Ali Abdulghani Binabdi

DOI:

https://doi.org/10.33178/SMJ.2021.1.5

Keywords:

blood pressure, subarachnoid haemorrhage, cerebral vasospasm

Abstract

Background

Trends in Blood Pressure (BP) following Subarachnoid Haemorrhage (SAH) have been reported in literature since 1982. Recent studies suggest a correlation to the incidence of Cerebral Vasospasm. This renders BP a candidate for possible early detection of Vasospasm. However, conflicting results regarding the nature and numerical of this correlation exist.

Objectives

To determine trends in BP following SAH in terms of Systolic (SBP), Diastolic (DBP) and Mean Arterial Pressure (MAP) and collaborate current literature evidence of their association to Cerebral Vasospasm.

Methods

Two databases (EBSCO Medline and PubMed) systematically reviewed using specified search criteria. Thirteen studies were portrayed, of which ten were accessible. Thorough critical appraisal of each paper was then manually performed using the CASP Cohort study checklist.

Results

A consistent pattern of change is seen through time in majority of studies with differences in the definite values of the BP variables. Collation of results showed a gradual rise in SBP followed by a plateau of 154.08 (±10.79) mmHg on days 4-8 post-SAH. Variations exist with regards to the association with Cerebral Vasospasm: a third of the studies depicted a significant steeper rise in SBP in Vasospasm patients, another third conversely reported sudden drops in SBP, and one study concluded that MAP has no significant relation to Vasospasm.

Conclusion

A biphasic trend is expected following SAH with an initial gradual rise followed by a sustained hypertensive plateau. Considerable conflict exists in the nature of association between BP and Vasospasm. Further analysis of such beneficial predictive potential is recommended for advancement in Vasospasm and Neuro-Cardiogenic care.

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