Hypertension Complicating Carotid Endarterectomy

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.