Cervical Ganglion Sympathectomy to Treat Cerebral Vasospasm in Subarachnoid Hemorrhage.
Neurocrit Care
; 39(1): 241-249, 2023 08.
Article
in En
| MEDLINE
| ID: mdl-36828982
ABSTRACT
Delayed cerebral ischemia (DCI) is still a significant cause of death and disability after aneurysmal subarachnoid hemorrhage. Cerebral vasospasm represents one of the most reported mechanisms associated with DCI. The management of DCI-related vasospasm remains a significant challenge for clinicians; induced hypertension, intraarterial vasodilators, and/or intracranial vessel angioplasty-particularly in refractory or recurrent cases-are the most used therapies. Because an essential role in the pathophysiology of cerebral vasospasm has been attributed to the adrenergic sympathetic nerves, a "sympatholytic" intervention, consisting of a temporary interruption of the sympathetic pathways using local anesthetics, has been advocated to minimize the vascular narrowing and reverse the consequences of cerebral vasospasm on tissue perfusion. In this review, we have analyzed the existing literature on the block of the cervical ganglions, particularly the stellate ganglion, in managing refractory cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. These findings could help clinicians to understand the potential role of such intervention and to develop future interventional trials in this setting.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Subarachnoid Hemorrhage
/
Brain Ischemia
/
Vasospasm, Intracranial
Limits:
Humans
Language:
En
Journal:
Neurocrit Care
Journal subject:
NEUROLOGIA
/
TERAPIA INTENSIVA
Year:
2023
Document type:
Article
Affiliation country:
Belgium