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Intracerebral Haemorrhage — SCE Neurology MCQ

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ModerateCerebrovascular DiseaseIntracerebral HaemorrhageSCE Neurology

A 62-year-old woman presents 2 hours after sudden onset of right-sided weakness. CT head shows a left basal ganglia intracerebral haemorrhage (30 mL volume). Her blood pressure is 210/115 mmHg. She is on no anticoagulants. What is the most appropriate blood pressure target?

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Correct answer: A — Systolic <140 mmHg

The INTERACT2 trial and subsequent guidelines support intensive blood pressure lowering to a systolic target of <140 mmHg within 6 hours of onset for acute spontaneous intracerebral haemorrhage, which is safe and may improve functional outcomes. A: 180 mmHg is too permissive. C: <120 mmHg may risk cerebral hypoperfusion. D: 160 mmHg is suboptimal. E: Untreated hypertension is associated with haematoma expansion.

Reference: RCP National Clinical Guideline for Stroke (2023); INTERACT2 Trial (2013)