[Labile hypertension due to iatrogenic denervation of the carotid sinus].
Two patients, a man and a woman aged 36 and 40 years, respectively, were found to have disturbed blood pressure regulation after medical intervention in the jugular area. The man had undergone radiation therapy of the neck due to regional lymph node involvement of a nasopharyngeal carcinoma. Six years later he developed episodic complaints of headache accompanied by labile hypo- and hypertension. Mental and physical stimuli resulted in excessive sympathetic activation. In the woman, a carotid body tumour was resected bilaterally. There was an immediate onset of hypertension after surgery. In both patients, the clinical syndrome was attributed to afferent baroreflex failure due to carotid sinus denervation.
Timmers
H J
HJ
Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen. h.timmers@aig.azn.nl
Wieling
W
W
Karemaker
J M
JM
Marres
H A
HA
Lenders
J W
JW
D000328:Adult; D017704:Baroreflex / Q000528:radiation effects; D002345:Carotid Body Tumor / Q000601:surgery; D002346:Carotid Sinus / Q000293:injuries / Q000294:innervation* / Q000528:radiation effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery