OpenHealth Q&A

Managing High Blood Pressure Following Meningioma Surgery: Seeking Insights

Greetings, I am reaching out in hopes of gathering insights regarding my mother’s condition, which is causing me considerable concern. She underwent a surgical procedure on February 12 to remove a meningioma, measuring 5 cm, located in the right frontal lobe. The medical team indicated that the tumor is likely benign, and her recovery process has been promising thus far. Remarkably, she had no significant complications and was able to leave the hospital by February 16. However, on February 15, just prior to her discharge, her blood pressure unexpectedly spiked. In the hospital, readings frequently hovered around 170–180 / 90–98. The healthcare staff responded by administering intravenous medication, which typically helped lower her blood pressure to about 130–140 / 80–85. The nursing staff advised that if her blood pressure remains elevated at home, a consultation with an internal medicine specialist is essential, and she may need to start blood pressure medication. Right after her discharge, she was admitted to a traditional medicine facility. Upon her arrival, her blood pressure was still elevated at approximately 165/92, prompting us to procure a prescription for a blood pressure medication in advance. Later that evening, her blood pressure rose again to 180/100, and she took her prescribed medication. The doctor who had recommended this medication suggested that due to the high readings, she should take the initial dose in the evening, followed by daytime doses the next day, and then switch to a morning regimen starting the following day. After administering the medication, her blood pressure dropped to around 150/90. However, during the night, her readings remained elevated between 160 and 170 systolic, despite her resting. This morning (February 17), after taking other prescribed medications from the surgical facility – including steroids, stomach protectants, pain relief, anti-seizure drugs, and medication for constipation – her blood pressure was recorded at 138/73. In the afternoon, she took her blood pressure medication again, and by 8 PM, her blood pressure was 153/85. I have several pressing questions regarding her situation: 1. Given that her physician recommended varying the timing of her blood pressure medication (evening on the first day, daytime today, and transitioning to morning doses thereafter), if her blood pressure escalates again tonight, would it be safe for her to take another dose on the same day? 2. If her blood pressure only reduces from approximately 180/95 to 150/90 post-medication, does this indicate a potential need for a stronger or alternative medication? 3. Is experiencing elevated blood pressure, particularly at night, a frequent occurrence for patients following brain surgeries like meningioma removal? 4. Could factors such as swelling in the brain, steroid usage, pain, or the stress of the surgical procedure be contributing to these elevated blood pressure readings? We intend to consult with her healthcare providers, but the anxiety is hard to manage, and I would be grateful for any preliminary medical advice or reassurance during this time. Post-surgery Medication Regimen: Here’s a list of the medications my mother is currently taking after her neurosurgery: 1. **Pain Relief** - **Acetaminophen + Tramadol (Cetamadol)** - Administration: After meals, three times daily (morning, lunch, and evening) - Purpose: To manage post-surgical pain. 2. **Steroid** - **Dexamethasone 0.5 mg** - Administration: Post-breakfast and dinner - Purpose: To mitigate brain swelling post-surgery. 3. **Anti-Seizure** - **Lacosamide 100 mg** - Administration: Twice daily (morning and evening) - Purpose: To prevent seizures following brain surgery. 4. **Stomach Protectant** - **Tegoprazan 50 mg** - Administration: Once daily after breakfast - Purpose: To guard against stomach irritation due to steroids and other medications. 5. **Constipation Relief/Antacid** - **Magnesium Hydroxide 500 mg** - Administration: After meals, three times daily - Purpose: To prevent constipation prompted by pain medications and limited activity post-surgery. 6. **Blood Pressure Medication** - **Amlodipine + Valsartan (Exduo 5 mg / 80 mg)** - Administration: Once daily (timing adjusted by the doctor: initial evening dose, daytime dose today, and every morning moving forward) - Purpose: To address elevated blood pressure following her surgery. Thank you very much for your assistance and support.

Answers (1)

2/17/2026, 8:30:53 PM

OpenHealth AI

Summary: Your mother's recent elevated blood pressure readings after meningioma surgery are concerning but can be managed. There are several factors to consider, and I will address your questions with supportive, clear guidance.

Explanation:

1. Blood Pressure Management Post-Surgery: After surgery, it's not uncommon for blood pressure to fluctuate due to multiple factors such as stress, pain, and medications (especially steroids). The blood pressure medication she is prescribed, Amlodipine + Valsartan, is commonly used for this purpose.

2. Monitoring and Reacting: If her blood pressure rises significantly again tonight, you should consider the recommended dosing schedule. While it can sometimes be safe to take an additional dose on the same day if her readings are still high and under medical guidance, it's crucial to follow the specific instructions given by her healthcare provider.

Prioritized Next Steps:

1. Monitor Blood Pressure:

   • Continue to take her blood pressure regularly, noting both the systolic (the top number) and diastolic (the bottom number) readings.
   • Record these readings, including the time, to help her healthcare provider assess her patterns.

2. Follow Medication Guidelines:

   • Adhere to the prescribed medication schedule. If her blood pressure readings exceed 180 systolic again, consult with her healthcare provider on whether another dose is appropriate, especially if it's still close to her next scheduled dose.

3. Symptom Management:

   • Try to manage pain and anxiety, which may be contributing to her elevated blood pressure. Ensure she takes her pain relief medication as prescribed and discuss non-medication strategies for anxiety with her doctors.

4. Identify Contributing Factors:

   • Factors like brain swelling from surgery and steroid use can indeed influence blood pressure. Dexamethasone may lead to increased fluid retention and elevated blood pressure. Regularly discuss her medications with her healthcare team to reassess their necessity and impact on her blood pressure.

5. Schedule Follow-Up Appointments:

   • Plan to discuss her current blood pressure management and medication effectiveness with her healthcare provider during her next appointment. Bring your recorded blood pressure logs for a detailed review.

Reassurance:

It's understandable to feel anxious during this time, especially with the changes in her health. The surgical team and internal medicine specialists are experienced in managing postoperative complications such as hypertension. Keeping an open line of communication with them, along with monitoring her condition closely, is the best pathway for assuring her well-being. Continue to support her during this recovery, and please don't hesitate to reach out for further questions or concerns.