PURPOSE: Evaluate current practice in a university hospital on management of high blood-pressure in patients in the acute phase of brain infarction (BI). METHODS: A case report of a lucid patient admitted 8 hours after onset of a BI with normal CT and high blood pressure (BP= 186/110 mmHg) was presented to staff members and resident physicians (departments of neurology and neurosurgery excluded). Responders were asked to decide as to the best therapeutic option: no treatment/ reduction/ elevation of BP. RESULTS: 27 of 44 responders (61%) considered BP reduction as the best treatment option. The same trend was observed among residents (16/27: 60%) and staff members (11/17: 65%); among surgeons (6/12: 50%) and clinicians (20/30: 67%). CONCLUSIONS: BP reduction in the hyperacute phase of BI may be harmfull. This basic concept of BI management has not been adequately assimilated by physicians of our university hospital, including those recently graduated. The results of this study signal to the urgent need of a wide diffusion of current concepts on pathophysiology and treatment of BI. Organization of stroke units may contribute to better patient management, medical education and research.
cerebral infarction; arterial hipertension; education, medical; internship and medical residence