{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:48:42Z","timestamp":1781761722471,"version":"3.54.5"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,7]]},"abstract":"<jats:p>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\u2009hours 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\u2013biochemical 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\u2019s reflex would at least contribute partly, if not solely to the respiratory distress.<\/jats:p>","DOI":"10.1136\/bcr-2018-226639","type":"journal-article","created":{"date-parts":[[2018,9,26]],"date-time":"2018-09-26T04:54:26Z","timestamp":1537937666000},"page":"bcr-2018-226639","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cushing\u2019s reflex secondary to neck haematoma following thyroidectomy"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-7393","authenticated-orcid":false,"given":"K","family":"Devaraja","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipak Ranjan","family":"Nayak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Rao","family":"Kordcal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet Suresh","family":"Malapure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,9,25]]},"reference":[{"key":"2025042706222140000_2018.sep25_1.bcr-2018-226639.1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1089\/thy.2017.0543","article-title":"Systematic review and meta-analysis of unplanned reoperations, emergency department visits and hospital readmission after thyroidectomy","volume":"28","author":"Margolick","year":"2018","journal-title":"Thyroid"},{"key":"2025042706222140000_2018.sep25_1.bcr-2018-226639.2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7824"},{"key":"2025042706222140000_2018.sep25_1.bcr-2018-226639.3","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/coa.12407","article-title":"Postoperative Systolic Blood Pressure as a risk factor for haematoma following thyroid surgery","volume":"40","author":"Morton","year":"2015","journal-title":"Clin Otolaryngol"},{"key":"2025042706222140000_2018.sep25_1.bcr-2018-226639.4","first-page":"343","article-title":"Postoperative hematomas after thyroid surgery. 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