Cushing's reflex secondary to neck haematoma following thyroidectomy

Devaraja, K and Nayak, Dipak Ranjan and Rao, Abhishek Kordcal and Malapure, Sumeet S (2018) Cushing's reflex secondary to neck haematoma following thyroidectomy. BMJ Case Report. pp. 1-4. ISSN 1757-790X

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Neck haematoma following thyroid surgery can present with respiratory distress which is generally attributed to airway obstruction. We recently had a 63-year-old female patient who underwent total thyroidectomy for toxic nodular goitre. However, within 4 hours of surgery,she developed sudden respiratory distress which was managed by prompt evacuation of the neck haematoma.Just before the haematoma evacuation, the patient had hypertension and bradycardia along with the distress.The arterial blood gas analysis sampled at that time was normal. Intraoperatively, the tracheal framework was found rigid and non-pliable. Considering the various clinical–biochemical findings observed, we think that the cause of the respiratory distress in the index case was transiently elevated intracranial pressure, secondary to bilateral internal jugular veins’ compression. We hypothesise that in many patients with immediate postoperative neck haematoma, the Cushing’s reflex would at least contribute partly, if not solely to the respiratory distress.

Item Type: Article
Subjects: Medicine > KMC Manipal > Anaesthesiology
Medicine > KMC Manipal > ENT
Medicine > KMC Manipal > Radiotherapy and Oncology
Depositing User: KMC Library
Date Deposited: 06 Oct 2018 10:02
Last Modified: 06 Oct 2018 10:02

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