Early cervical sympathectomy for management of cerebral vasospasm in traumatic head injuries a cross sectional prospective study

Introduction : Head trauma is a leading cause for both death and disability among patients (3),. It can result in a wide range of pathological conditions (7), with cerebral vasospasm being a frequently encountered complication (1,8), Several treatment approaches are employed to manage cerebral vasospasm (6), cervical symoathectomy in the form of stellate ganglion block is one of these methods (11) Aim of the study : assessment of the effect of cervical sympathectomy on the reduction of cerebral vasospasm primarily and secondarily the impact of this reduction on patient follow-up and prognosis. Methods : 30 adult patients with isolated head trauma injury had a bilateral ultrasound-guided stellate block with 8 ml 0.5% bupivacaine and 40 mg of betamethasone.Patient follow-up included hemodynamics, Transcranial-Doppler for middle cerebral artery, basilar artery, GCS, and improvement and motor deficit after one week of follow-up. Results : we found that cerebral vasospasm improved, MCA measurements improved in comparison to baseline at 1 ^ST day, 2 ^ND day, and after one week, (P value < 0.001). GCS was better in comparison to baseline after one week (P value < 0.001). MBP was unaffected in comparison to the baseline, after 15, 30, and 60 minutes. Conclusion : Early cervical sympathectomy is an efficient method for the reduction of cerebrovascular spasm after traumatic brain injury.Ckinical trials registry number NCT05182619, registry date 10/12/2021