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What Causes Labile Hypertension After Spine Surgery?

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Posted on Mon, 27 Jul 2015
Question: I am 74. Fat and sedentary I had hypertension from 40on but since my spine surgery it has become quite labile. is it cured or related to something else that could cause patterns of presentation. I also had intercranial hypertension in childhood and eventually in my sixties a blinding venal occlusion in the right eye where my childhood pain occurred. There is a cavernous sinus issue below the tight eye. Any guesses?

I also have audio halucinations, and hearing loss in certain environmental situations. I am fine on the phone normally and good with an FM communicator.

Also have hypothyroidism and typ 2 diabetes treated by glyburide and harmones.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
There are different causes mimicking this clinical scenario

Detailed Answer:
Hello!

Thank you for asking on HCM!

Regarding your concern, I would like to explain that your high blood pressure may be related to different causes:

1. A cervical spine surgery can cause labile high blood pressure, in case of a spinal damage. The region in the central nervous system responsible for the blood pressure lies in the cervical spine. A damage during surgery can cause liability of the blood pressure, but also cardiac arrhythmia ( because these regions are also responsible for the cardiac rhythm).
Normally there is a lowering of the blood pressure after cervical spine decompression surgery, but in rare cases if the spine is damaged the opposite can occur.

2. Thyroid dysfunction can cause changes in blood pressure. A higher dose of thyroid hormone intake can mimic this clinical scenario. I recommend you performing thyroid hormone levels, to exclude this as a possible cause.

3. Intracranial hypertension. Your past medical history is very concerning. This disorder can cause changes in the blood pressure. The blood pressure and intracranial pressure are closely related by several reflexes. An increase in the intracranial pressure can cause high blood pressure. The hearing problems may also be related to this disorder. Other symptoms like headache and nausea can be caused by this disorder.

I recommend consulting with a neurologist for a careful physical examination and perform a brain CT scan or MRI. If you have undergone cervical spine surgery, it may be necessary to extend the examination (brain and cervical spine). An ophtalmological examination may also be necessary to exclude possible papilledema caused by intracranial hypertension.

4. Secondary high blood pressure. There are different causes like kidney dysfunction, metabolic causes, thyroid dysfunction, etc. which can cause your symptoms. It is necessary to perform a detailed check up, including an ECG, cardiac ultrasound, kidney and liver function tests, blood electrolytes, abdominal ultrasound for the kidneys to exclude other possible causes.

5.Primary high blood pressure. Your suffer from diabetes and in your age, you have different risks for developing a primary high blood pressure.
If all the above mentioned tests result normal, the most probable diagnosis would remain a primary high blood pressure.

In this case an anti-hypertensive treatment would be necessary.

Hope to have been helpful!

Feel free to ask any questions whenever you need!

Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
I am 74 and feel pretty good in spite of all this.

my readings are are typically 155/83 and have been as low as 117/55.
That is since my lamenectomy.


Before the operation under stressi got readings of 210/98

As a practical matter, at my age and with my bad experiences with the four classes of hypertensive drugs. is my quality of life seriously impaired if I just lose weight, hydrate and live a quiet lifestyle?




doctor
Answered by Dr. Ilir Sharka (9 hours later)
Brief Answer:
Controlling your blood pressure values will improve your quality of life.

Detailed Answer:

Hello!

Seems that your blood pressure is much better after laminectomy.

You are advised to keep monitoring closely your BP values.

Controlling your body weight, following a healthy life-style and diet, will help to reduce the rest and exercise BP values even more.

I still insist, you should pursue with the above mentioned recommendations, as it would be a good review of your actual clinical status, and would address the arrangements of important key points to be adjusted (regarding treatment and appropriate follow up).

Wish you a good health! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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What Causes Labile Hypertension After Spine Surgery?

Brief Answer: There are different causes mimicking this clinical scenario Detailed Answer: Hello! Thank you for asking on HCM! Regarding your concern, I would like to explain that your high blood pressure may be related to different causes: 1. A cervical spine surgery can cause labile high blood pressure, in case of a spinal damage. The region in the central nervous system responsible for the blood pressure lies in the cervical spine. A damage during surgery can cause liability of the blood pressure, but also cardiac arrhythmia ( because these regions are also responsible for the cardiac rhythm). Normally there is a lowering of the blood pressure after cervical spine decompression surgery, but in rare cases if the spine is damaged the opposite can occur. 2. Thyroid dysfunction can cause changes in blood pressure. A higher dose of thyroid hormone intake can mimic this clinical scenario. I recommend you performing thyroid hormone levels, to exclude this as a possible cause. 3. Intracranial hypertension. Your past medical history is very concerning. This disorder can cause changes in the blood pressure. The blood pressure and intracranial pressure are closely related by several reflexes. An increase in the intracranial pressure can cause high blood pressure. The hearing problems may also be related to this disorder. Other symptoms like headache and nausea can be caused by this disorder. I recommend consulting with a neurologist for a careful physical examination and perform a brain CT scan or MRI. If you have undergone cervical spine surgery, it may be necessary to extend the examination (brain and cervical spine). An ophtalmological examination may also be necessary to exclude possible papilledema caused by intracranial hypertension. 4. Secondary high blood pressure. There are different causes like kidney dysfunction, metabolic causes, thyroid dysfunction, etc. which can cause your symptoms. It is necessary to perform a detailed check up, including an ECG, cardiac ultrasound, kidney and liver function tests, blood electrolytes, abdominal ultrasound for the kidneys to exclude other possible causes. 5.Primary high blood pressure. Your suffer from diabetes and in your age, you have different risks for developing a primary high blood pressure. If all the above mentioned tests result normal, the most probable diagnosis would remain a primary high blood pressure. In this case an anti-hypertensive treatment would be necessary. Hope to have been helpful! Feel free to ask any questions whenever you need! Greetings! Dr. Iliri