Acute intra-operative hypertensive crises may be attributed to episodic surges of thyroid hormones (thyroid storm) or a neurogenic baroreflex phenomenon due to surgical manipulation near the carotid sinus.3,4 Thyroid storm in an emergency situations characterized by persistent hypertension, tachycardia, hyperthermia, and end-organ damage.4 The neurogenic baroreflex affects cardiac contractility, heart rate and systemic vascular resistance by mechanoreceptors those located around aortic arch and carotid arteries. The gene discussed is TG; the disease is thyroid crisis.