Cervical Sympathectomy for Cerebral Vasospasm after Aneurysm Rupture

Abstract

The authors report a series of 11 cases of ruptured intracranial aneurysms followed by cerebral vasospasm manifesting neurological deficits. These patients were treated by cervical sympathectomy consisting of perivascular sympathectomy of the cervical internal carotid artery and superior cervical ganglionectomy on the same side as the cerebral angiospasm. Improvement of symptoms was observed following 13 procedures in 11 patients, within 10 hours in four cases, on the next day in five cases, and by the seventh day in two cases. In the remaining two cases no beneficial effect was observed. This technique was most valuable when it was done immediately after the appearance of the symptoms of infarction, before the development of irreversible brain damage.