Cervical Sympathetic Block in Patients With Cerebral Vasospasm
Anesthesia, Local, Cerebral Vasospasm, Subarachnoid Hemorrhage, Aneurysmal
About this trial
This is an interventional treatment trial for Anesthesia, Local focused on measuring regional anesthesia, cervical sympathectomy, cerebral blood flow
Eligibility Criteria
Inclusion Criteria:
- ages 18 and over
- patients hospitalized in the ICU and developing cerebral vasospasm after aneurysmal subarachnoid hemorrhage
Exclusion Criteria:
- known advanced stage kidney disease
Sites / Locations
- Stanford University
Arms of the Study
Arm 1
Experimental
Cervical sympathetic block
Patients hospitalized in the ICU and developing clinical manifestations of cerebral vasospasm will undergo a computerized tomography (CT) angiography and a CT perfusion scan. If the vasospasm will be confirmed by the CT imaging, a cervical sympathetic nerve block under ultrasound guidance will be performed. The block consists in the deposition of local anesthetic at the cervical sympathetic ganglion that will be visualized with an ultrasound device. A periganglionar catheter will be left in place. A CT angiography and CT perfusion will be repeated to check the effect of the block on the brain vasculature after the block is done. Patients will have a daily monitoring of their neurological function and of their cerebral blood flow with transcranial doppler in the ICU.