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April 2, 1955


JAMA. 1955;157(14):1219. doi:10.1001/jama.1955.02950310045010

There is always a tendency in emergency treatment to use any means that might possibly benefit the patient. It often requires courage to withhold such a treatment for the purpose of accumulating enough controls to make a critical evaluation possible. This inevitably gives rise to controversy. Such a controversy exists with regard to the value of stellate ganglion block in the emergency treatment of apoplexy. De Takats1 favors this procedure on the basis that (1) clinical reports show early improvement in the neurological signs and symptoms in patients so treated; (2) this treatment decreases cerebral vascular resistance; (3) in 60% of the cases of cerebral infarction there was no postmortem evidence of occlusion of the cerebral vessels by embolism, thrombosis, or arteriosclerosis, and in only a few was there shock or heart failure, thus pointing to vasoconstriction as the cause of ischemia; (4) it produces increased vascularity of the

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