Paroxysmal hypertension can occur after
radiation to the head and neck. Patients exhibit sudden elevation of blood
pressure (> 200/110 mm Hg) associated with an abrupt onset of headache,
chest pain, dizziness, nausea, palpitations, flushing, and sweating.
A recent case report in Journal of
Medical Ultrasound describes a laryngectomee who experienced repeated
paroxysmal hypertensive episodes following direct massage of the carotid artery
during Doppler ultrasound of the neck.
The radiation damage to the carotid
artery baroreceptors might have increased their hypersensitivity to the
mechanical and ultrasonic stimulation during the diagnostic test, leading to
the hypertensive episodes. It is recommended that patients who had received
radiation therapy for head and neck cancer and require Doppler ultrasound of
the carotid artery should be monitored for paroxysmal hypertension by recording their blood pressure
prior and after the test.
