Cervical sympathetic trunk

The cervical sympathetic trunk contains three interconnected ganglia: the superior, middle, and inferior cervical ganglia. In 80% of people, the lowest cervical ganglion is fused with the first thoracic ganglion to form the cervicothoracic stellate ganglion.

A simple treatment such as a cervical sympathetic nerve block may be an effective therapy but is not routinely performed to treat vasospasm/DCI. cervical sympathetic nerve block consists of injecting local anesthetic at the level of the cervical sympathetic trunk, which temporarily blocks the innervation of the cerebral arteries to cause arterial vasodilatation. cervical sympathetic nerve block is a local, minimally invasive, low cost and safe technique that can be performed at the bedside and may offer significant advantages as a complementary treatment in combination with more conventional neurointerventional surgery interventions. Bombardieri et al. reviewed the literature that describes cervical sympathetic nerve block for vasospasm/DCI prevention or treatment in humans after aSAH. The studies outlined in this review show promising results for a cervical sympathetic nerve block as a treatment for vasospasm/DCI. Further research is required to standardize the technique, explore how to integrate a cervical sympathetic nerve block with conventional neurointerventional surgery treatments of vasospasm and DCI, and study its long-term effect on neurological outcomes ¹⁾.