O bloqueio do gânglio estrelado nas tromboses e embolias cerebrais agudas

• Autor(a) principal: Armbrust-figueiredo, Jorge [UNIFESP]
• Data de Publicação: 1954
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-282X1954000200009; http://repositorio.unifesp.br/handle/11600/124

The author presents the results obtained by using the stellate ganglion block in 43 cases of acute cerebral vascular accidents. Thirty one patients had cerebral thrombosis with no complications, 5 had thrombosis complicated by cardiac decompensation and 7 had cerebral embolism. In all cases the blocks were made by using a one per cent solution of procaine hydrochloride and the ganglion was always reached using the anterior approach. The stellate blocks were always made as early as possible and repeated every 12 hours, at least during the first four days. The results obtained were considered according to the type of vascular accident and to the time between the onset of symptoms and the stellate block. The best results were obtained in those patients who received treatment within the first 16 hours after the onset of their symptoms. From 32 patients 20 showed immediate improvement after the first block and 31 patients showed marked improvement after the eighth block. Eight patients had the first stellate block between 17 and 24 hours after the onset of their symptoms; 2 showed immediate improvement and 4 had improved after the onset of their symptoms; 2 showed immediate improvement and 4 had improved after the eighth block. Two patients had the stellate block 24 or more hours after the onset of the symptoms and did not show any improvement. According to the type of vascular accidents, the best results were obtained in that group of uncomplicated thrombosis. From 31 patients 28 showed marked improvement at the fourth day of treatment. Two patients out of 5 with complicated thrombosis and 5 out of 7 with cerebral embolism had good recovery. Electroencephalogram were recorded in 11 cases immediately prior and 1 hour and 4 hours after the first stellate block. The correlation betweei* the changes in the EEG and the clinical picture was always present. The cerebral blood flow was obtained in 5 cases immediately prior and 5 hours after the first block. Even though 4 patients had presented clinical improvement only in one case the blood flow showed increase in its value after the first block. The author concludes thai the stellate block is the best treatment at present time for acute cerebral thrombosis and embolism.