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Hypertension After Severe Traumatic Brain Injury: Friend or Foe?

Krishnamoorthy, Vijay MD, MPH*,†; Chaikittisilpa, Nophanan MD*,†; Kiatchai, Taniga MD*,†; Vavilala, Monica MD*,†

Journal of Neurosurgical Anesthesiology: October 2017 - Volume 29 - Issue 4 - p 382–387
doi: 10.1097/ANA.0000000000000370
Review Article

Traumatic brain injury (TBI) is a major public health problem, with severe TBI contributing to a large number of deaths and disability worldwide. Early hypotension has been linked with poor outcomes following severe TBI, and guidelines suggest early and aggressive management of hypotension after TBI. Despite these recommendations, no guidelines exist for the management of hypertension after severe TBI, although observational data suggests that early hypertension is also associated with an increased risk of mortality after severe TBI. The purpose of this review is to discuss the underlying pathophysiology of hypertension after TBI, provide an overview of the current clinical data on early hypertension after TBI, and discuss future research that should test the benefits and harms of treating high blood pressure in TBI patients.

*Department of Anesthesiology and Pain Medicine, University of Washington

Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA

Supported by NIH Funding (National Research Service Award T32 GM086270).

The authors have no conflicts of interest to disclose.

Address correspondence to: Vijay Krishnamoorthy, MD, MPH, Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, BB-1469 Seattle, WA 98195 (e-mail:

Received February 18, 2016

Accepted August 5, 2016

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