Hypertensive Encephalopathy After Bilateral Carotid Endarterectomy
| Autor: | M. Haguenau, O. Corabianu, J. M. Idatte, F. Woimant, O. Ille, A. Pruna |
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| Rok vydání: | 1995 |
| Předmět: |
Male
Tachycardia Hypertensive encephalopathy Baroreceptor Valsalva Maneuver Vomiting medicine.medical_treatment Carotid endarterectomy Heart Rate medicine Valsalva maneuver Humans Psychomotor Agitation Endarterectomy Advanced and Specialized Nursing Brain Diseases Endarterectomy Carotid Reflex Abnormal business.industry Headache Baroreflex Middle Aged medicine.disease Blood pressure Anesthesia Hypertension cardiovascular system Epilepsy Tonic-Clonic Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business Grand mal seizure |
| Zdroj: | Stroke. 26:488-491 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.26.3.488 |
| Popis: | Background Hypertension occurs frequently after carotid endarterectomy and may lead to cerebral vascular complications and myocardial infarction. Its pathophysiology has recently been related to surgically induced damage of carotid baroreceptors. Case Description A 45-year-old normotensive man with no history of epilepsy was admitted 3 weeks after bilateral carotid endarterectomy for severe repetitive paroxysmal headaches, vomiting, and agitation that were closely associated with attacks of marked hypertension. During one of these attacks, he had a grand mal seizure. Plasma catecholamine levels during hypertensive attacks were highly elevated despite the absence of pheochromocytoma, reflecting abnormalities in baroreceptor sensitivity that lead to unrestrained activation of the central sympathetic nervous system. Heart rate response to Valsalva maneuver showed suppression of the usual tachycardia, indicating baroreceptor reflex insensitivity. Conclusions We report the first case of hypertensive encephalopathy associated with baroreflex failure syndrome after bilateral carotid endarterectomy. The role of blood pressure monitoring may be critical in revealing carotid baroreceptor insensitivity in such clinical settings. |
| Databáze: | OpenAIRE |
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