Hypertension. 2004;44:1-5
Published online before print May 10, 2004, doi: 10.1161/01.HYP.0000129170.50448.5f
Published online before print May 10, 2004, doi: 10.1161/01.HYP.0000129170.50448.5f
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(Hypertension. 2004;44:1.)
© 2004 American Heart Association, Inc.
Hypertension Grand Rounds |
Chronic Management of Blood Pressure After Stroke
From the Department of Neurology and Rehabilitation, University of Illinois at Chicago.
Correspondence to Laura Pedelty, MD, PhD, Department of Neurology and Rehabilitation, University of Illinois at Chicago, Neuropsychiatric Institute North Tower, 912 South Wood Street MC 796, Chicago, IL 60612. E-mail pedelty@uic.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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A 70-year-old, right-handed African American woman with diabetes mellitus, treated with an oral hypoglycemic, and untreated mild hypertension developed right-sided face, arm, and leg weakness while at home preparing breakfast. She was able to reach the telephone and dial 911. An ambulance was summoned, and the Emergency Medical Service team, on arrival, noted a right facial droop, dysarthria, and right-sided weakness. She was transported to a local hospital, arriving within an hour of the onset of the event. The hospital stroke team was consulted and initiated an evaluation.
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Physical Examination |
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The patient was afebrile, with a pulse of 72 and a blood pressure of 170/90 mm Hg. Neck was supple with no carotid bruits. Temporal arteries were nontender. Heart was regular with no murmurs or gallops. Peripheral pulses were 2+, and capillary refill was good. There were no peripheral bruits.
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Neurological Examination |
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She was awake, lucid, alert, and well oriented. She did not report headache. Speech was dysarthric, but comprehension was good and she spoke in fully formed sentences. There was no sensory neglect or extinction. Cranial nerve examination revealed equal, reactive pupils and full visual fields; funduscopic examination disclosed grade I hypertensive changes. She had a flattened nasolabial fold on the right, but was able to close her eyes and wrinkle her forehead. Motor examination revealed impaired fine motor movements in the right hand, pronator drift of the outstretched right arm, and mild proximal weakness of the right leg; sensory examination revealed decreased vibratory sensation in the distal feet bilaterally. Tendon reflexes were
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