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Hypertension, Vascular Headaches, and Seizures After Carotid EndarterectomyCase Report and Therapeutic Considerations
James G. Dolan, MD;
Alvin I. Mushlin, MD
Arch Intern Med. 1984;144(7):1489-1491.
Abstract
• The following three unusual complications of carotid endarterectomy developed in a 64-year-old woman: vascular headaches, delayed hypertension, and seizures. β-Blockade with propranolol hydrochloride had no beneficial effect on either the hypertension or the headaches. Peripheral  -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 β-blockade in this setting and suggest that the role of prazosin in the initial management of postendarterectomy hypertension and vascular headache be explored.
(Arch Intern Med 1984;144:1489-1491)
Author Affiliations
From the Department of Medicine, General Medicine Unit, University of Rochester (NY) School of Medicine and Dentistry. Dr Dolan is a Henry J. Kaiser Family Foundation Fellow.
Footnotes
Accepted for publication June 17, 1983.
Reprints not available.
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