TEN Neurologia Practice Questions - TEN - Título De Especialista Em Neurologia (Academia Brasileira De Neurologia AMB) Exam

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A 55-year-old man with uncontrolled hypertension presents with sudden severe headache, vomiting, and right hemiplegia. Cranial CT reveals a 35 mL spontaneous intracerebral hemorrhage (ICH) centered in the left putamen with mild surrounding edema and intraventricular extension into the left lateral ventricle. His initial Glasgow Coma Scale (GCS) score is 11, and he is 55 years old (age < 80). His initial blood pressure is 210/115 mmHg. According to the original ICH Score (Hemphill et al.) and acute ICH management guidelines, what is his calculated ICH score and recommended acute target systolic blood pressure?

ICH score of 2; target systolic blood pressure rapidly lowered and maintained between 130 and 140 mmHg. ICH score of 4; target systolic blood pressure lowered strictly below 110 mmHg. ICH score of 1; blood pressure should not be lowered to avoid compromising cerebral perfusion pressure. ICH score of 3; target systolic blood pressure maintained between 160 and 180 mmHg.

Correct Answer:

ICH score of 2; target systolic blood pressure rapidly lowered and maintained between 130 and 140 mmHg.

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