Regional Anesthesia & Pain Medicine · 2023 · 11 citations · 15 references
MedicineNeurologyNeuroscienceAnesthesiaClinical NeuroscienceNeurocritical CareAutonomic DisordersAutonomic Nervous SystemAutonomic Nervous System PharmacologyAutonomic Nervous System ResponsesAutonomic PharmacologyHydrocephalus ManagementAutonomic Dysfunction After Brain InjuryAutonomic ToneGanglionic BlockersParoxysmal Sympathetic HyperactivitySympathetic ActivationSympathetic BlocksSympathetic Nerve BlocksSympathetic Nervous System Dysfunction
BACKGROUND: Paroxysmal sympathetic hyperactivity (PSH) is an autonomic disorder affecting patients with severe acquired brain injury characterized by intermittent sympathetic discharges with limited therapeutic options. We hypothesized that the PSH pathophysiology could be interrupted via stellate ganglion blockade (SGB). CASE PRESENTATION: A patient with PSH after midbrain hemorrhage followed by hydrocephalus obtained near-complete resolution of sympathetic events for 140 days after SGB. CONCLUSION: SGB is a promising therapy for PSH, overcoming the limitations of systemic medications and may serve to recalibrate aberrant autonomic states.
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