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.
- Autonomic Nerve Block
- Neurologic Manifestations
- REGIONAL ANESTHESIA
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Contributors M-CL was involved in patient care plans and follow-up and was the key developer of the discussion and literature review required. AB was involved in direct patient care, care plans, extracting patient data from the medical record, writing up the case history, and reviewing manuscript drafts. JC was involved in patient care plans, placement of the stellate ganglion block catheter, production of the procedural video, patient follow-up, and review of manuscript drafts. RKK was involved in patient care plans/consultation and manuscript review/editing and preparation. SJ was involved in patient evaluation and consultation regarding the feasibility of stellate ganglion blockade and was directly involved with manuscript preparation and review. FM was involved in patient care, responsible for the idea of stellate ganglion block and performance of the block, production/editing of the video and figures, manuscript preparation and editing, and overall content of the report.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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