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March 1965

Cervical Sympathectomy and Cerebrospinal Fluid Pressure: Their Relationship to Brain Metabolism

Author Affiliations

From the Surgical Research Laboratory of Veterans Administration Hospital, Perry Point, Md, and Johns Hopkins University, School of Medicine, Baltimore.

Arch Surg. 1965;90(3):418-421. doi:10.1001/archsurg.1965.01320090096022

WE reported in 196110 the late postoperative effect of superior cervical sympathetic ganglionectomy on the cerebral blood flow (CBF) of normal dogs. An increased intracranial pressure was considered a possible explanation of a slight decrease rather than the expected increase in CBF during the late postoperative follow-up (one to two years). This was supported by Kety's7 finding a decreased cerebral metabolic rate of oxygen (CMR O2) in patients with increased intracranial pressure. His reported CMR O2 rate was identical to the rate on our dogs subjected to bilateral superior cervical sympathetic ganglionectomy (2.94 ml O2/100 gm brain weight/minute).10

The mean venous pressure (MVP) is generally considered to parallel the mean cerebral spinal fluid pressure (Bering2). A decreased MVP of 46.5 mm normal saline (NS) was found on our sympathectomized dogs during the late follow-up. This suggested that sympathectomy may have only a

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