Neurocritical care and periprocedural blood pressure management in acute stroke.

The purpose of this article is to review the literature on periprocedural blood pressure (BP) management in acute ischemic stroke and to establish guidelines regarding management of BP. These guidelines are drawn from available evidence and expert opinion. This article reviews the pathophysiologic considerations of BP in ischemic stroke. It also examines the natural history of BP changes during stroke, as well as data on induced BP reduction and hypertension, particularly in light of reperfusion therapy. Finally, the article reviews major ongoing clinical trials for BP management in this setting. Recommendations made in this article may serve as a benchmark for future research in BP management in this patient population.