Cervical Sympathetic Block for Cerebral Vasospasm

Recruiting in Palo Alto (17 mi)

Overseen byAnna Maria Bombardieri, MD, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Stanford University

No Placebo Group

Trial Summary

What is the purpose of this trial?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.

Eligibility Criteria

This trial is for adults over 18 who are in the ICU with cerebral vasospasm following a brain aneurysm bleed. It's not suitable for those with advanced kidney disease.

Inclusion Criteria

I am in the ICU due to brain vessel spasms after a brain bleed from an aneurysm.

I am 18 years old or older.

Exclusion Criteria

My kidney disease is in an advanced stage.

Participant Groups

The study tests whether a cervical sympathetic block, which is an injection near the neck to interrupt nerve signals, can improve blood flow in the brain and neurological recovery after a subarachnoid hemorrhage.

1Treatment groups

Experimental Treatment

Group I: Cervical sympathetic blockExperimental Treatment1 Intervention

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.