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In our routine clinical care setting, we implemented stellate ganglion block (SGB) as a rescue therapy with subsequent escalation to intraarterial spasmolysis (IAS) with milrinone for refractory CV.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this retrospective analysis from 2012 to 2021, patients with CV following aneurysmal subarachnoid hemorrhage who received an SGB or IAS were identified. Patients were assessed through neurological examination and transcranial Doppler. Rescue therapy was performed in patients with mean cerebral blood flow velocity (CBFV)\u2009\u2265\u2009120\u00a0cm\/s and persistent neurological deterioration\/intubation under induced hypertension. Patients were reassessed after therapy and the following day. The Glasgow Outcome Scale was assessed at discharge and 6-month follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 82 patients (mean age 50.16\u00a0years) with 184 areas treated with SGB and\/or IAS met the inclusion criteria; 109 nonaffected areas were extracted as controls. The mean CBFV decrease in the middle cerebral artery on the following day was\u2009\u2212\u200930.1 (\u00b1\u200945.2) cm\/s with SGB and\u2009\u2212\u200931.5 (\u00b1\u200945.2) cm\/s with IAS. Mixed linear regression proved the significance of the treatment categories; other fixed effects (sex, age, aneurysm treatment modality [clipping or coiling], World Federation of Neurological Surgeons score, and Fisher score) were insignificant. In logistic regression, the presence of cerebral infarction on imaging before discharge from the intensive care unit (34\/82) was significantly associated with unfavorable outcomes (Glasgow Outcome Scale\u2009\u2264\u20093) at follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Stellate ganglion block and IAS decreased CBFV the following 24\u00a0h in patients with CV. We suggest SGB alone for patients with mild symptomatic CV (CBFV\u2009&lt;\u2009180\u00a0cm\/s), while subsequent escalation to IAS proved to be beneficial in patients with refractory CV and severe CBFV elevation (CBFV\u2009\u2265\u2009180\u00a0cm\/s).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12028-023-01762-w","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T13:01:39Z","timestamp":1690462899000},"page":"603-611","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Stellate Ganglion Block and Intraarterial Spasmolysis in Patients with Cerebral Vasospasm: A Retrospective Cohort Study"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1182-4067","authenticated-orcid":false,"given":"Christopher","family":"Wendel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Oberhauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Schiff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Henkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Ganslandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"issue":"1","key":"1762_CR1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/s13054-016-1447-6","volume":"20","author":"CL Francoeur","year":"2016","unstructured":"Francoeur CL, Mayer SA. 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He is also a shareholder of CONTARA GmbH. The remaining authors have no conflicts of interest to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"We confirm the adherence to ethical guidelines. The approval of the local ethics committee in Baden-Wurttemberg, Germany was issued under No. F-2016\u2013107.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval\/Informed Consent"}}]}}