Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives
We report a case of a 72 year old hypertensive male who developed severe hypertension followed by neurological deterioration in the immediate postoperative period after transurethral resection of prostate. While arterial blood gas and laboratory tests excluded transurethral resection of prostate syn...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-07-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001416300938 |
| _version_ | 1811200586490576896 |
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| author | Deb Sanjay Nag Abhishek Chatterjee Devi Prasad Samaddar Ajay Agarwal |
| author_facet | Deb Sanjay Nag Abhishek Chatterjee Devi Prasad Samaddar Ajay Agarwal |
| author_sort | Deb Sanjay Nag |
| collection | DOAJ |
| description | We report a case of a 72 year old hypertensive male who developed severe hypertension followed by neurological deterioration in the immediate postoperative period after transurethral resection of prostate. While arterial blood gas and laboratory tests excluded transurethral resection of prostate syndrome or any other metabolic cause, reduction of blood pressure failed to ameliorate the symptoms. A cranial CT done 4 hours after the onset of neurological symptoms revealed bilateral gangliocapsular and right thalamic infarcts. Oral aspirin was advised to prevent early recurrent stroke. Supportive treatment and mechanical ventilation ensured physiological stability and the patient recovered completely over the next few days without any residual neurological deficit. Resumo: Relatamos o caso de um paciente hipertenso, 72 anos, que desenvolveu hipertensão grave seguida de deterioração neurológica no pós-operatório imediato após ressecção transuretral de próstata. Embora os testes laboratoriais e a gasometria tenham excluído a síndrome de ressecção transuretral de próstata ou qualquer outra causa metabólica, a diminuição da pressão sanguínea não conseguiu melhorar os sintomas. Uma tomografia computadorizada craniana, realizada 4 horas após o aparecimento de sintomas neurológicos, revelou infartos gangliocapsular bilateral e talâmico à direita. AAS oral foi aconselhado para prevenir um acidente vascular cerebral recorrente precoce. O tratamento de apoio e a ventilação mecânica garantiram a estabilidade fisiológica e o paciente obteve recuperação completa durante os próximos dias, sem qualquer déficit neurológico residual. Keywords: Transurethral resection of prostate, Perioperative period, Stroke, Hypertension, Neurologic manifestations, Unconsciousness, Palavras-chave: Ressecção transuretral de próstata, Perioperatório, Acidente vascular cerebral, Hipertensão, Manifestações neurológicas, Inconsciência |
| first_indexed | 2024-04-12T02:05:59Z |
| format | Article |
| id | doaj.art-a60e656d937549e0b642fb7ff0385267 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T02:05:59Z |
| publishDate | 2018-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-a60e656d937549e0b642fb7ff03852672022-12-22T03:52:33ZengElsevierBrazilian Journal of Anesthesiology0104-00142018-07-01684388391Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save livesDeb Sanjay Nag0Abhishek Chatterjee1Devi Prasad Samaddar2Ajay Agarwal3Tata Main Hospital, Department of Anesthesiology & Critical Care, Jamshedpur, India; Corresponding author.Tata Main Hospital, Department of Anesthesiology & Critical Care, Jamshedpur, IndiaTata Main Hospital, Department of Anesthesiology & Critical Care, Jamshedpur, IndiaTata Main Hospital, Department of Urology, Jamshedpur, IndiaWe report a case of a 72 year old hypertensive male who developed severe hypertension followed by neurological deterioration in the immediate postoperative period after transurethral resection of prostate. While arterial blood gas and laboratory tests excluded transurethral resection of prostate syndrome or any other metabolic cause, reduction of blood pressure failed to ameliorate the symptoms. A cranial CT done 4 hours after the onset of neurological symptoms revealed bilateral gangliocapsular and right thalamic infarcts. Oral aspirin was advised to prevent early recurrent stroke. Supportive treatment and mechanical ventilation ensured physiological stability and the patient recovered completely over the next few days without any residual neurological deficit. Resumo: Relatamos o caso de um paciente hipertenso, 72 anos, que desenvolveu hipertensão grave seguida de deterioração neurológica no pós-operatório imediato após ressecção transuretral de próstata. Embora os testes laboratoriais e a gasometria tenham excluído a síndrome de ressecção transuretral de próstata ou qualquer outra causa metabólica, a diminuição da pressão sanguínea não conseguiu melhorar os sintomas. Uma tomografia computadorizada craniana, realizada 4 horas após o aparecimento de sintomas neurológicos, revelou infartos gangliocapsular bilateral e talâmico à direita. AAS oral foi aconselhado para prevenir um acidente vascular cerebral recorrente precoce. O tratamento de apoio e a ventilação mecânica garantiram a estabilidade fisiológica e o paciente obteve recuperação completa durante os próximos dias, sem qualquer déficit neurológico residual. Keywords: Transurethral resection of prostate, Perioperative period, Stroke, Hypertension, Neurologic manifestations, Unconsciousness, Palavras-chave: Ressecção transuretral de próstata, Perioperatório, Acidente vascular cerebral, Hipertensão, Manifestações neurológicas, Inconsciênciahttp://www.sciencedirect.com/science/article/pii/S0104001416300938 |
| spellingShingle | Deb Sanjay Nag Abhishek Chatterjee Devi Prasad Samaddar Ajay Agarwal Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives Brazilian Journal of Anesthesiology |
| title | Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives |
| title_full | Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives |
| title_fullStr | Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives |
| title_full_unstemmed | Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives |
| title_short | Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives |
| title_sort | perioperative stroke following transurethral resection of prostate high index of suspicion and stabilization of physiological parameters can save lives |
| url | http://www.sciencedirect.com/science/article/pii/S0104001416300938 |
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