Abstract:
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.
journal_name
Strokejournal_title
Strokeauthors
Ille O,Woimant F,Pruna A,Corabianu O,Idatte JM,Haguenau Mdoi
10.1161/01.str.26.3.488subject
Has Abstractpub_date
1995-03-01 00:00:00pages
488-91issue
3eissn
0039-2499issn
1524-4628journal_volume
26pub_type
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