The Safety and Efficacy of Ultrasound-Guided Stellate Ganglion Block and Nimodipine for Treating Cerebral Vasospasm Following Trauma

Aly, Nourhan Assem; Mohamed, Alaa Mohamed; Mohamed, Ahmed Elsaady; Fouda, Enas Mahmoud

doi:10.21608/ejhm.2025.415220.1822

The Safety and Efficacy of Ultrasound-Guided Stellate Ganglion Block and Nimodipine for Treating Cerebral Vasospasm Following Trauma

Document Type : Original Article

Authors

¹ internal medicine department faculty of medicine Ain Shams University

² internal medicine department faculty of medicine Ain Shams university

³ Internal Medicine Department faculty of medicine Ain Shams University

⁴ Internal Medicine Department Faculty of Medicine Ain Shams University

10.21608/ejhm.2025.415220.1822

Abstract

Background: Cerebral vasospasm (CV) is a common complication after traumatic brain injury (TBI), with its underlying mechanisms not well understood, complicating the development of effective management strategies.
Objectives: The study aimed to compare the safety and efficacy of ultrasound-guided stellate ganglion block (SGB) and nimodipine therapy (NT) as preventive measures against CV after TBI.
Patients and methods: The study examined adult patients diagnosed with cerebral vasospasm (CV) following TBI. Evaluation methods included trans-cranial Doppler (TCD) and neurological assessments. Patients in the NT group received symptomatic treatment via ultrasound-guided stellate ganglion block (SGB) daily for one week. Therapeutic outcomes were assessed through mean cerebral blood flow velocity (MBFV), Glasgow Coma Scale (GCS), and the Modified Rankin score.
Results: No procedure- or medication-related deaths were documented throughout the course of the study. With a P < 0.001, the MBFV of the middle cerebral artery (MCA) showed a significant decrease in both groups as compared to the baseline. Following treatment, the SGB group's MBFV of MCA was significantly higher than the NT group's, with a p-value of 0.047. There was no significant difference in complication rates between the two groups. The modified Rankin score was observed to be significantly higher in the SGB group compared to the NT group (P < 0.01).
Conclusion Ultrasound-guided SGB and NT demonstrated comparable efficacy in mitigating CV risk among patients with TBI. SGB can serve as a supplementary treatment alternative, particularly in cases where conventional approaches are inappropriate or yield insufficient results.

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