Document Detail

Catecholamine-associated refractory hypertension following acute intracranial hemorrhage: control with propranolol.
MedLine Citation:
PMID:  7224599     Owner:  NLM     Status:  MEDLINE    
Seven patients (4 with subarachnoid hemorrhage, 2 with intracerebral hemorrhage, and 1 with massive cerebral infarction) had acute arterial hypertension refractory to control by several antihypertensive drugs (hydralazine, sodium nitroprusside, alpha-methyldopa, and trimethaphan camsylate) used singly or in combination. In each case, catecholamine excretion--measured by urinary norepinephrine plus epinephrine--was markedly elevated, averaging 218 microgram/day. Patients without the acute refractory hypertension had normal or only slightly elevated urinary catecholamine levels (mean, 72 microgram/day). The beta-adrenergic blocking agent propranolol, in doses between 20 and 40 mg every 6 hours, successfully controlled blood pressure, while other agents failed. The intense sympathetic nervous system discharge resulting in acute refractory hypertension may be due to injury to the diencephalon or brainstem (or both) or to diffuse brain dysfunction from increased intracranial pressure or intracranial blood.
J H Feibel; C A Baldwin; R J Joynt
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of neurology     Volume:  9     ISSN:  0364-5134     ISO Abbreviation:  Ann. Neurol.     Publication Date:  1981 Apr 
Date Detail:
Created Date:  1981-06-25     Completed Date:  1981-06-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  340-3     Citation Subset:  IM    
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Cerebral Hemorrhage / complications*,  urine
Epinephrine / urine*
Hypertension / drug therapy*,  urine
Intracranial Aneurysm / complications
Middle Aged
Norepinephrine / urine*
Propranolol / therapeutic use
Subarachnoid Hemorrhage / complications
Grant Support
Reg. No./Substance:
0/Antihypertensive Agents; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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