Stellate ganglion block catheter for paroxysmal sympathetic hyperactivity: calming the ‘neuro-storm’
Man-Cheung Lee, Andrew Bartuska, Jeffrey S. Chen, Richard Kim, Safwan Jaradeh, Frederick G. Mihm
Abstract
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.
Topics & Concepts
MedicineHydrocephalusMidbrainStellate ganglionAnesthesiaSympathetic ganglionAutonomic nervous systemInternal medicineCardiologySurgeryCentral nervous systemHeart ratePathologyAlternative medicineBlood pressureTraumatic Brain Injury and Neurovascular DisturbancesCardiovascular Syncope and Autonomic DisordersNeurosurgical Procedures and Complications