title: Baroreflex failure: a rare complication of carotid paraganglioma surgery.
abstract: Multiple head and neck paragangliomas are a rare occurrence. We report a patient with removal of bilateral carotid paragangliomas who subsequently developed baroreflex failure 1 month after surgery. The pathology and physiology of this presentation is extremely interesting because it exhibits the complex homeostatic mechanisms involved in the maintenance of steady-state blood pressure. Although rare, it is important to be aware of baroreflex failure and its variable course. Most postsurgical cases occur within days of surgery but, as this report demonstrates, hypertensive urgency can occur weeks to months after surgery; and if not recognized early, it can lead to disastrous postoperative complications such as stroke and myocardial infarction.
authors.affiliation: Department of Otolaryngology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas 78236-5550, USA. Stephen.Maturo@lackland.af.mil
authors.forename: Stephen
authors.initials: S
authors.lastname: Maturo
authors.forename: Joseph
authors.initials: J
authors.lastname: Brennan
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017704:Baroreflex; D002345:Carotid Body Tumor / Q000473:pathology* / Q000601:surgery*; D002346:Carotid Sinus / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis*; D035583:Rare Diseases; D012021:Reflex, Abnormal; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D000959:Antihypertensive Agents