Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives

Deb Sanjay Nag; Abhishek Chatterjee; Devi Prasad Samaddar; Ajay Agarwal

doi:10.1016/j.bjane.2016.05.003

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Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives

Acidente vascular cerebral no perioperatório após ressecção transuretral de próstata: alto índice de suspeita e estabilização de parâmetros fisiológicos podem salvar vidas

Deb Sanjay Nag; Abhishek Chatterjee; Devi Prasad Samaddar; Ajay Agarwal

http://dx.doi.org/10.1016/j.bjane.2016.05.003 Braz J Anesthesiol, vol.68, n4, p.388-391, 2018

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Abstract

Abstract 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.

Keywords

Transurethral resection of prostate, Perioperative period, Stroke, Hypertension, Neurologic manifestations, Unconsciousness

Resumo

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.

Palavras-chave

Ressecção transuretral de próstata, Perioperatório, Acidente vascular cerebral, Hipertensão, Manifestações neurológicas, Inconsciência

Referências

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Perioperative stroke following transurethral resection of prostate: high index of suspicion and stabilization of physiological parameters can save lives

Acidente vascular cerebral no perioperatório após ressecção transuretral de próstata: alto índice de suspeita e estabilização de parâmetros fisiológicos podem salvar vidas

Deb Sanjay Nag; Abhishek Chatterjee; Devi Prasad Samaddar; Ajay Agarwal

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