Cervical Sympathetic Block in Patients With Cerebral Vasospasm

Not Applicable

• Conditions: Anesthesia, Local; Cerebral Vasospasm; Subarachnoid Hemorrhage, Aneurysmal
• Interventions: Procedure: Cervical sympathetic block

• Registration Number: NCT05230134
• Lead Sponsor: Stanford University

Brief Summary

The purposes of this study are twofold: 1) to assess the effect of a cervical sympathetic block on cerebral blood flow in patients suffering from cerebral vasospasm, after aneurysmal subarachnoid hemorrhage; 2) to evaluate the effect of the sympathetic block on the recovery of the neurological function.

Detailed Description

Patients hospitalized in the intensive care unit (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.

Basic Information
|
Recruitment & Eligibility
|
Study & Design
|
Trial Locations

Study Timeline

• Study First Submitted: 2022-01-19
• Study First Submitted QC: 2022-02-07
• Study First Posted: 2022-02-08
• Study Start: 2023-07-27
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-21
• Last Update Posted: 2024-11-25
• Primary Completion: 2025-12
• Study Completion: 2025-12

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 10

Inclusion Criteria

• ages 18 and over
• patients hospitalized in the ICU and developing cerebral vasospasm after aneurysmal subarachnoid hemorrhage

Read More

Exclusion Criteria

• known advanced stage kidney disease

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Cervical sympathetic block	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.

Primary Outcome Measures

Name	Time	Method
Cerebral blood flow	1 hour after the block	Cerebral blood flow as measured by computed tomography perfusion
Neurological function	Duration of recovery in ICU (1-2 weeks)	Change in neurological status as assessed by the Glasgow Coma Scale. The Glasgow Coma Scale score can range from 3 (completely unresponsive) to 15 (responsive).

Secondary Outcome Measures

Name	Time	Method
Cerebral blood flow velocity	Daily during recovery in ICU (1-2 weeks)	Transcranial doppler measurement

Trial Locations

Locations (1)

Stanford University; 🇺🇸 Stanford, California, United States