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Cervical Sympathectomy in Selected Cases of Low-Grade Cerebral Arterial Insufficiency: A Preliminary Study.
Bahij S. Salibi, M.D.Low-grade cerebral arterial insufficiency may be manifested by recurrent small strokes, postural vertigo, dizziness, and/or mental fogginess aggravated by prolonged standing. The symptoms are usually reproducible by unilateral manual carotid occlusion. Four such cases are reported, with complete temporary relief of symptoms following bilateral cervical sympathetic block. Three were subsequently treated with bilateral cervical sympathectomy after unsuccessful trial on ephedrine and papaverine. A postoperative follow-up of five months to four years has shown complete relief of postural vertigo and mental fogginess in all three. None had had strokes. None have objected to their postoperative Claude Bernard-Horner syndrome. Only one has suffered from postoperative nasal congestion. Nasal congestion was partly due to marked preexisting nasal septal deviation. The fourth case obtained prolonged relief of several days or weeks after each bilateral
Brown M. CHICAGO NEUROLOGICAL SOCIETY. Arch Neurol. 1960;3(4):457–458. doi:10.1001/archneur.1960.00450040107013