Hypertension, vascular headaches, and seizures after carotid endarterectomy. Case report and therapeutic considerations.

Abstract

The following three unusual complications of carotid endarterectomy developed in a 64-year-old woman: vascular headaches, delayed hypertension, and seizures. beta-Blockade with propranolol hydrochloride had no beneficial effect on either the hypertension or the headaches. Peripheral alpha-blockade with prazosin hydrochloride resulted in prompt improvement in the patient's condition. Altered autonomic vascular control secondary to carotid sinus trauma is proposed as a possible causative mechanism for all three complications. The therapeutic implications are discussed. Based on this experience, we would caution against the use of unopposed beta-blockade in this setting and suggest that the role of prazosin in the initial management of postendarterectomy hypertension and vascular headache be explored.

• Authors: J G Dolan, A I Mushlin
• Journal: Archives of internal medicine (Arch Intern Med) Vol. 144 Issue 7 Pg. 1489-91 (Jul 1984) ISSN: 0003-9926 [Print] United States
• PMID: 6732410 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Propranolol
• Prazosin
• Phenobarbital

Topics

• Carotid Arteries (surgery)
• Endarterectomy (adverse effects)
• Female
• Humans
• Hypertension (drug therapy, etiology)
• Middle Aged
• Phenobarbital (therapeutic use)
• Prazosin (therapeutic use)
• Propranolol (therapeutic use)
• Seizures (drug therapy, etiology)
• Vascular Headaches (drug therapy, etiology)