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(Stroke. 1970;1:307.)
© 1970 American Heart Association, Inc.

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Hypertension Complicating Carotid Endarterectomy

MICHAEL S. LEHV M.D.¹; EDWIN W. SALZMAN M.D.¹; WILLIAM SILEN M.D.¹

¹ Department of Surgery, Harvard Medical School; Surgical Services, Beth Israel Hospital, 330 Brookline Avenue, Boston, Massachusetts, 02215

Fifteen of 27 patients became hypertensive after unilateral carotid endarterectomy; seven of these experienced neurological deterioration, which persisted more than a week in five patients. Neurological worsening did not occur in patients without postoperative hypertension, which developed primarily in patients with a preoperative disturbance of consciousness or other neurological deficit, especially in those with seizure activity. There was no correlation with preoperative blood pressure, the time of arteriography, arteriographical or operative findings, use of an internal shunt, or other features of operative or anesthetic technique. Serum sodium concentration was significantly lower in hypertensive patients, although fluid administration did not vary in the two patient groups.

Key Words: seizure • internal arteriography • internal shunt • serum sodium

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