The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Tuesday, May 6, 2008

Sympathectomy - extracranial steal phenomenon

Unilateral cerebral infarcts were produced in the rat by ligation of one common carotid artery and subsequent exposure to carbon monoxide. The incidence and extension of brain infarcts was increased in animals with additional ipsilateral cervical preganglionic sympathectomy. Sympathectomy did not affect markedly the respiration and systemic circulation. The effect of sympathectomy was attributed to a cutaneous vasodilation, leading to an extracranial steal phenomenon.

Cerebral infarction due to carotid occlusion and carbon monoxide exposure. II. Influence of preganglionic cervical sympathectomy.
J Igloffstein and R Laas

J Neurol Neurosurg Psychiatry. 1983 August; 46(8): 768–773.

Cerebral blood flow is no longer constant after sympathectomy

Cerebral blood flow remains relatively constant and is in-
dependent of modest fluctuations in arterial pressure,
presumably because of its capacity for autoregulation.22-23
After cervical sympathectomy, however, one group reported
that cerebral blood flow rate is no longer constant but varies
with arterial pressure.

The demonstration that non-uniform changes in blood flow
between cortical lobes and between hemispheres could be in-
duced by ischemia26 and neurogenic stimulation26 probably
implicates neurogenic factors. There is some evidence for
heterogeneity of the function of the sympathetic neurons
originating from the superior cervical ganglion.



Adrenergic lnnervation of Large Cerebral Blood
Vessels of the Rabbit Studied by Fluorescence Microscopy
Absence of Features That Might Contribute to Non-Uniform Change
in Cerebral Blood Flow
RALPH E. PURDY, PH.D.,* AND JOHN A. BEVAN, M.D.

STROKE VOL 8, No 1, JANUARY-FEBRUARY 1977

Sympathetic regulation of cerebral blood flow

AJP - Heart and Circulatory Physiology, Vol 249, Issue 3 672-H680, Copyright © 1985 by American Physiological Society


Sympathetic regulation of cerebral blood flow during reflex hypertension

P. Lacombe, M. C. Miller and J. Seylaz

Sympathectomy may result in profound hypotension

Regional anesthetic techniques such as
spinal or epidural anesthesia, though efficacious in
providing surgical anesthesia and sensory deafferenta-
tion, are often avoided because they produce bilateral
sympathectomy. This may result in profound hypoten-
sion that can be difficult to treat in HOCM patients.
Paravertebral somatic nerve blocks for breast
surgery in a patient with hypertrophic obstructive
cardiomyopathy

Chester C. Buckenmaier III MD, Susan M. Steele MD, Karen C. Nielsen MD, Stephen M. Klein MD
CAN J ANESTH 2002 / 49: 6 / pp 571–574
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