{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T21:11:09Z","timestamp":1650402669061},"reference-count":12,"publisher":"Akademiai Kiado Zrt.","issue":"42","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orvosi Hetilap"],"published-print":{"date-parts":[[2014,10]]},"abstract":"Cerebral autoregulation is essential in the maintenance of cerebral blood flow. Due to this autoregulation, cerebral perfusion is constant in healthy subjects if blood pressure values are between 50\u2013150 mmHg. In hypertensive patients the curve is right-shifted towards higher blood pressure values (pathological autoregulation). Aggressive blood pressure reduction can lead to severe ischaemia. The authors report the history of a 73-year-old man with the background history of widespread atherosclerotic disease. The patient complained about headache and dizziness and was found to have high blood pressure (160\/100 mmHg) and increased blood glucose (14.8 mmol\/l). Prior to his admission an aggressive blood pressure and blood sugar reduction was carried out and, within a short period of time he became unconscious and was transferred to the department of the authors with the possible diagnosis of brainstem stroke. On admission the patient was unresponsive, comatose with brainstem symptoms. Urgent brain computed tomography failed to show any acute alterations. However, repeat CT scan revealed extensive bilateral space occupying ischemic changes involving in territories of both internal carotid arteries with consequent brainstem compression. Computed tomography angiography confirmed bilateral internal carotid artery occlusion. The authors conclude that intensive blood pressure reduction result in ischemic lesions via hypoperfusion especially in patients with widespread atherosclerotic disease and significant carotid vessel pathology. Orv. Hetil., 2014, 155(42), 1685\u20131689.<\/jats:p>","DOI":"10.1556\/oh.2014.30011","type":"journal-article","created":{"date-parts":[[2014,10,12]],"date-time":"2014-10-12T01:00:49Z","timestamp":1413075649000},"page":"1685-1689","source":"Crossref","is-referenced-by-count":1,"title":["Unfavorable outcome of aggressive lowering of high blood pressure. Case report"],"prefix":"10.1556","volume":"155","author":[{"given":"Di\u00e1na","family":"Kuperczk\u00f3","sequence":"first","affiliation":[{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Neurol\u00f3giai Klinika P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"Cs\u00e9csei","sequence":"additional","affiliation":[{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Neurol\u00f3giai Klinika P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hedvig","family":"Kom\u00e1romy","sequence":"additional","affiliation":[{"name":"P\u00e9csi Diagnosztikai K\u00f6zpont P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Szap\u00e1ry","sequence":"additional","affiliation":[{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Neurol\u00f3giai Klinika P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gergely","family":"Feh\u00e9r","sequence":"additional","affiliation":[{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Neurol\u00f3giai Klinika P\u00e9cs"},{"name":"Szigetv\u00e1ri K\u00f3rh\u00e1z Neurol\u00f3giai Oszt\u00e1ly Szigetv\u00e1r Szent Istv\u00e1n ltp. 7. 7900"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"1","unstructured":"College of Internal Medicine and Hungarian Society of Hypertension: Guideline of the Ministry of Health: Treatment of hypertension. [A Belgy\u00f3gy\u00e1szati Szakmai Koll\u00e9gium \u00e9s a Magyar Hypertonia T\u00e1rsas\u00e1g: Az Eg\u00e9szs\u00e9g\u00fcgyi Miniszt\u00e9rium szakmai ir\u00e1nyelve: A hypertoniabetegs\u00e9g kezel\u00e9se.] Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zl\u00f6ny, 2006, 5<\/i>(2). CD [Hungarian]"},{"key":"2","doi-asserted-by":"crossref","unstructured":"Mayer, S. A., Kurtz, P., Wyman A., et al., STAT Investigators:<\/i> Clinical practices, complications, and mortality in neurological patients with acute severe hypertension: the STAT Registry. Crit. Care Med., 2011, 39<\/i>(10), 2330\u20132336.","DOI":"10.1097\/CCM.0b013e3182227238"},{"key":"3","unstructured":"Komoly, S., Palkovits, M.:<\/i> Practical Neurology and Neuroanatomy. [Gyakorlati neurol\u00f3gia \u00e9s neuranat\u00f3mia.] Medicina K\u00f6nyvkiad\u00f3, Budapest, 2010. [Hungarian]"},{"key":"4","unstructured":"Andr\u00e1ssy, G.:<\/i> Hypertensive emergencies. [Hipert\u00f3ni\u00e1s kr\u00edzis\u00e1llapotok.] http:\/\/www.viranyosklinika.hu\/WEBSET_DOWNLOADS\/642\/hipertoniaskrizisallapotok.pdf<\/a> [Hungarian]"},{"key":"5","doi-asserted-by":"crossref","unstructured":"Mancia, G., Fagard, R., Narkiewicz, K., et al.:<\/i> 2013 ESH\/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J., 2013, 34<\/i>(28), 2159\u20132219.","DOI":"10.1093\/eurheartj\/eht151"},{"key":"6","doi-asserted-by":"crossref","unstructured":"Kitiyakara, C., Guzman, N., J.:<\/i> Malignant hypertension and hypertensive emergencies. J. Am. Soc. Nephrol., 1998, 9<\/i>(1), 133\u2013142.","DOI":"10.1681\/ASN.V91133"},{"key":"7","doi-asserted-by":"crossref","unstructured":"Rothwell, P. M., Howard, S. C., Spence, J. D.:<\/i> Relationship between blood pressure and stroke risk in patients with symptomatic carotid occlusive disease. Stroke, 2003, 34<\/i>(11), 2583\u20132590.","DOI":"10.1161\/01.STR.0000094424.38761.56"},{"key":"8","unstructured":"College of Neurology and Hungarian Society of Stroke: Guideline of the Ministry of Health for treatment of cerebrovascular diseases. (2nd modified version.) [Neurol\u00f3giai Szakmai Koll\u00e9gium \u00e9s Magyar Stroke T\u00e1rsas\u00e1g: Az Eg\u00e9szs\u00e9g\u00fcgyi Miniszt\u00e9rium szakmai ir\u00e1nyelve a cerebrovascularis betegs\u00e9gek ell\u00e1t\u00e1s\u00e1r\u00f3l (2. m\u00f3dos\u00edtott v\u00e1ltozat)]. Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zl\u00f6ny, 2010, 7<\/i>, 1605\u20131665. [Hungarian]"},{"key":"9","unstructured":"Chaithongdi, N., Subauste, J. S., Koch, C. A., et al.:<\/i> Diagnosis and management of hyperglycemic emergencies. Hormones (Athens). 2011, 10<\/i>(4), 250\u2013260."},{"key":"10","doi-asserted-by":"crossref","unstructured":"NICE-SUGAR Study Investigators, Finfer, S., Chittock, D. R., Su, S. Y., et al.:<\/i> Intensive versus conventional glucose control in critically ill patients. N. Engl. J. Med., 2009, 360<\/i>(13), 1283\u20131297.","DOI":"10.1056\/NEJMoa0810625"},{"key":"11","doi-asserted-by":"crossref","unstructured":"ACCORD Study Group, Gerstein, H. C., Miller, M. E., Genuth, S., et al.:<\/i> Long-term effects of intensive glucose lowering on cardiovascular outcomes. N. Engl. J. Med., 2011, 364<\/i>(9), 818\u2013828.","DOI":"10.1056\/NEJMoa1006524"},{"key":"12","unstructured":"Van den Born, B. J., Beutler, J. J., Gaillard, C. A., et al.:<\/i> Dutch guideline for the management of hypertensive crisis \u2013 2010 revision. Neth. J. Med., 2011, 69<\/i>(5), 248\u2013255."}],"container-title":["Orvosi Hetilap"],"original-title":[],"language":"hu","link":[{"URL":"https:\/\/www.akademiai.com\/doi\/pdf\/10.1556\/OH.2014.30011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T20:50:12Z","timestamp":1650401412000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/doi\/10.1556\/oh.2014.30011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":12,"journal-issue":{"issue":"42","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1556\/OH.2014.30011"],"URL":"https:\/\/doi.org\/10.1556\/oh.2014.30011","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]}}}