Cushing's reflex secondary to neck haematoma following thyroidectomy

K. Devaraja, Dipak Ranjan Nayak, Abhishek Rao Kordcal, Sumeet Suresh Malapure

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number226639
JournalBMJ Case Reports
Volume2018
DOIs
Publication statusPublished - 01-01-2018

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Thyroidectomy
Hematoma
Reflex
Neck
Nodular Goiter
Blood Gas Analysis
Intracranial Hypertension
Poisons
Jugular Veins
Airway Obstruction
Bradycardia
Thyroid Gland
Hypertension

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Devaraja, K. ; Nayak, Dipak Ranjan ; Kordcal, Abhishek Rao ; Malapure, Sumeet Suresh. / Cushing's reflex secondary to neck haematoma following thyroidectomy. In: BMJ Case Reports. 2018 ; Vol. 2018.
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Cushing's reflex secondary to neck haematoma following thyroidectomy. / Devaraja, K.; Nayak, Dipak Ranjan; Kordcal, Abhishek Rao; Malapure, Sumeet Suresh.

In: BMJ Case Reports, Vol. 2018, 226639, 01.01.2018.

Research output: Contribution to journalArticle

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AU - Nayak, Dipak Ranjan

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AU - Malapure, Sumeet Suresh

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