Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in suscep...

A 41-year-old woman presented with a short history of blurred vision. She had a 6-year history of refractory hypertension which had been treated with a variety of drug regimens. She was found to have bilateral branch retinal vein occlusion. Retinal vein occlusion is a recognised complication of hypertension but simultaneous involvement of both eyes is extremely rare. Following this episode, blo...

Eighty-five patients with refractory transformed migraine type of chronic daily headache (CDH) had spinal tap as a part of diagnostic work-up. Twelve had increased intracranial pressure without papilledema, transient visual obscurations, or visual field defects. The headache profile of these 12 patients was not different from that of transformed migraine type of CDH. Acute headache exacerbation...

Acute esophageal variceal hemorrhage is a terrible complication of portal hypertension and. rebleeding is very common in survivors of acute variceal bleeding. Traditional medical management options include the use of vasoconstrictor, balloon tamponade, and endoscopic therapy. Though endoscopic therapy has achieved successful hemostasis in the majority of acute variceal bleeding episodes, the ou...

Refractory intracranial hypertension is a leading cause of poor neurological outcomes in patients with severe traumatic brain injury. Decompressive craniectomy has been used in the management of refractory intracranial hypertension for about a century, and is presently one of the most important methods for its control. However, there is still a lack of conclusive evidence for its efficacy in te...

Background Refractory hypertension (RfH) is a severe phenotype of resistant (RH) linked to higher risk stroke and other adverse cardiovascular events, but knowledge about it still lacking. Objectives To evaluate the association between RfH stroke. Methods We conducted cross-sectional study in referral clinic for patients with period from 2018 2020. RH was defined as uncontrolled blood pressure ...

Agenesis of corpus callosum is a common congenital or developmental malformation of brain. This is a case report of 13 year old female presented with delayed milestones, mental retardation, refractory hypertension and pallor since childhood. She had dysmorphic facies in the form of thick eyebrows, hypertelorism, low anterior hairline, hirsuitism, broad nose, thickened lips and low set ears. Upp...

This study of guanfacine in 27 patients suffering from moderate-to-severe hypertension showed a satisfactory blood pressure control in 26 patients. Twenty-one of the 27 patients completed a one-year clinical trial with good blood pressure response. The new drugs, acting through the stimulation of the central alpha-adrenoceptors, are useful in patients suffering from moderate-to-severe hypertens...

Effective treatment of intracranial hypertension involves meticulous avoidance of factors that precipitate or aggravate increased intracranial pressure. When intracranial pressure becomes elevated, it is important to rule out new mass lesions that should be surgically evacuated. medical management of increased intracranial pressure should include sedation and paralysis, drainage of cerebrospina...

The hyponatremic hypertensive syndrome is a rare but serious complication of reno-vascular disease. The syndrome is characterized by hypertension and profound natriuresis, leading to body sodium and water depletion. Hypertension is typically refractory to treatment. We report an 82-year-old patient with this syndrome and describe the results of an audit of the clinical records of patients admit...