Target BP before thrombolysis in ischemic stroke is below?
**Core Concept**
The management of blood pressure (BP) in acute ischemic stroke is crucial to prevent further brain damage. The optimal target BP before thrombolysis is a topic of debate, but a key principle is to avoid excessive hypertension that may worsen brain edema and hemorrhagic transformation.
**Why the Correct Answer is Right**
The American Heart Association (AHA) and European Stroke Organization (ESO) guidelines recommend a target systolic blood pressure (SBP) of less than 185 mmHg before administering thrombolytic therapy. This is because higher BP values are associated with an increased risk of intracerebral hemorrhage (ICH) after thrombolysis. The goal is to maintain a BP that is low enough to prevent excessive bleeding, but not so low that it compromises cerebral perfusion.
**Why Each Wrong Option is Incorrect**
**Option A:** Not specified - This option lacks a specific BP value, making it an unsuitable choice for a target BP before thrombolysis.
**Option B:** This value is actually the recommended target BP for patients with acute ischemic stroke who are not candidates for thrombolysis, not those undergoing thrombolysis.
**Option C:** This value is too low and may compromise cerebral perfusion, increasing the risk of ischemic injury.
**Clinical Pearl / High-Yield Fact**
Remember the "BATCH" acronym to guide BP management in acute ischemic stroke: **B**rain edema, **A**void excessive hypertension, **T**arget BP < 185 mmHg, **C**ontrol BP variability, and **H**emodynamic monitoring.
**Correct Answer: B. 180**