Articles related to HYPOTENSION

A 29-member specialist interest group (SIG) was formed, comprising representation from neurology, neuroradiology, anesthesia, neurosurgery, and patient advocacy. The SIG unanimously agreed on the scope and purpose of the guideline. Using a modified Delphi method, the SIG then created guideline statements for a number of question themes. A rigorous literature study, surveys of patients and healthcare professionals, and a review by numerous international experts on SIH all contributed to this process. Any patient presenting with orthostatic headache should be evaluated for spontaneous intracranial hypotension (SIH) and its possible diagnosis. MRI of the brain with contrast and the whole spine should be used as first-line imaging. The non-targeted epidural blood patch (EBP) is the first-line treatment and should be performed as soon as possible. The authors discuss treatment ideas and present criteria for doing myelography based on the spine MRI result and response to EBP. There are also recommendations for conservative care, symptomatic headache treatment, and management of SIH consequences.

In 60 medical centers, 1,500 patients were randomized to either a restrictive or liberal fluid strategy. The 90-day mortality rate was 14% in the fluid-restrictive group and 14.9% in the liberal group, equating to statistical equivalence between the two approaches.

Hear, watch, or read the top-line observations from a Harris Poll that included more than 360 patients and 120 caregivers on the impact of symptomatic neurogenic orthostatic hypotension (nOH). Suffice, many described severe limitations to their ability to perform activities that are necessary for day-to-day living.

Can you determine the appropriate case management for a 68-year-old man who is evaluated for an episode of syncope and repeated episodes of near-fainting when standing and working on his tractor? On physical examination, vital signs are normal. Supine blood pressure is 124/78 mm Hg, and pulse rate is 76/min. After the patient stands for three minutes, standing blood pressure is 88/68 mm Hg, and pulse rate is 94/min. The remainder of the examination is normal. How would you proceed?

A study published in the Cleveland Clinic Journal of Medicine puts forward a new and systematic approach to diagnosing and managing orthostatic hypotension. The article notes that current approaches to evaluating and managing the disease are based on limited data, but that patients would benefit from more consistent diagnosis and treatment methods.