{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:42:50Z","timestamp":1793392970054,"version":"4.5.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Cerebral vasospasm (CV) is a delayed, sustained contraction of the cerebral arteries that tends to occur 3\u201314 days after aneurysmal subarachnoid hemorrhage (aSAH) from a ruptured aneurysm. Vasospasm potentially leads to delayed cerebral ischemia, and despite medical treatment, 1 of 3 patients suffer a persistent neurological deficit. Bedside transcranial Doppler (TCD) ultrasonography is used to indirectly detect CV through recognition of an increase in cerebral blood flow velocity (CBFV). The present study aimed to use TCD ultrasonography to monitor how CBFV changes on both the ipsi- and contralateral sides of the brain in the first 24 hours after patients have received a stellate ganglion block (SGB) to treat CV that persists despite maximum standard therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The data were culled from records of patients treated between 2013 and 2017. Patients were included if an SGB was administered following aSAH, whose CBFV was \u2265 120 cm\/sec and who had either a focal neurological deficit or reduced consciousness despite having received medical treatment and blood pressure management. The SGB was performed on the side where the highest CBFV had been recorded with 8\u201310 ml ropivacaine 0.2%. The patient\u2019s CBFV was reassessed after 2 and 24 hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Thirty-seven patients (male\/female ratio 18:19), age 17\u201370 years (mean age 49.9 \u00b1 11.1), who harbored 13 clipped and 22 coiled aneurysms (1 patient received both a coil and a clip, and 3 patients had 3 untreated aneurysms) had at least one SGB. Patients received up to 4 SGBs, and thus the study comprised a total of 76 SGBs.<\/jats:p><jats:p>After the first SGB, CBFV decreased in 80.5% of patients after 2 hours, from a mean of 160.3 \u00b1 28.2 cm\/sec to 127.5 \u00b1 34.3 cm\/sec (p &lt; 0.001), and it further decreased in 63.4% after 24 hours to 137.2 \u00b1 38.2 cm\/sec (p = 0.007). A similar significant effect was found for the subsequent SGB. Adding clonidine showed no significant effect on either the onset or the duration of the SGB. Contralateral middle cerebral artery (MCA) blood flow was not reduced by the SGB.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>To the authors\u2019 knowledge, this is the largest study on the effects of administering an SGB to aSAH patients after aneurysm rupture. The data showed a significant reduction in ipsilateral CBFV (MCA 20.5%) after SGB, lasting in about two-thirds of cases for over 24 hours with no major complications resulting from the SGB.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.5.jns182890","type":"journal-article","created":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T00:09:09Z","timestamp":1566000549000},"page":"773-779","source":"Crossref","is-referenced-by-count":24,"title":["Decrease of blood flow velocity in the middle cerebral artery after stellate ganglion block following aneurysmal subarachnoid hemorrhage: a potential vasospasm treatment?"],"prefix":"10.3171","volume":"133","author":[{"given":"Christopher","family":"Wendel","sequence":"first","affiliation":[{"name":"Neurosurgical Clinic and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Scheibe","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Klinikum Stuttgart, Germany;"},{"name":"Department of Anesthesiology, Kantonsspital M\u00fcnsterlingen, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Klinikum Stuttgart, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Tangemann","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Klinikum Stuttgart, Germany;"},{"name":"University of Heidelberg;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Henkes","sequence":"additional","affiliation":[{"name":"Neuroradiological Clinic, Klinikum Stuttgart; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Ganslandt","sequence":"additional","affiliation":[{"name":"Neurosurgical Clinic and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Henrik","family":"Schiff","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Klinikum Stuttgart, Germany;"},{"name":"Department of Anesthesiology and Intensive Care, Philipps-University Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurointerv Surg","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1136\/neurintsurg-2011-010248","article-title":"Invasive interventional management of post-hemorrhagic cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage","volume":"4","author":"Abruzzo T","year":"2012","unstructured":"Abruzzo T, Moran C, Blackham KA, Eskey CJ, Lev R, Meyers P, : Invasive interventional management of post-hemorrhagic cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. 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