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

Thursday, September 4, 2008

Headache Following Cervical Sympathectomy - Harvard Medical School

Headache Following Cervical Sympathectomy and Results of a Blood Flow Study in the Cat
Egilius L. H. Spierings, MD, PhD
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
Address all correspondence to Dr. Egilius L. H. Spierings, 25 Walnut Street, Suite 102, Wellesley Hills, MA 02481-2106.

Background.—A patient developed severe, continuous, unilateral headache that was "vascular" in nature, following cervical sympathectomy.

Objective.—To determine the changes in cranial blood flow in the cat following lesioning and stimulation of the cervical sympathetic nerve.

Method.—Carotid blood flow was determined by electromagnetic flowmetry and its tissue distribution by intra-arterial injection of 15-μm radioactive microspheres.

Results.—Following sympathetic lesioning, an increase in carotid blood flow was observed and reversed with stimulation. The distribution of carotid blood flow changed for the brain only, maintaining relatively constant tissue perfusion.

Conclusion.—An increase in cerebral blood flow could not have accounted for the sympathectomy-induced headache. Dilation of major cerebral arteries and cranial noncerebral vasodilation probably constitutes its mechanism.

Accepted for publication October 6, 2002


Cervical sympathectomy reduces the heterogeneity of oxygen saturation in small cerebrocortical veins

H. M. Wei, A. K. Sinha and H. R. Weiss

Department of Anesthesia, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway 08854-5635.

This study evaluated the hypothesis that the peripheral sympathetic nervous system is one of the factors increasing the heterogeneity of venous O2 saturation in selective brain regions. Regional cerebral blood flow and O2 saturation were determined in the anterior cortex, posterior cortex, and medulla of either sham-operated or bilaterally sympathectomized Long-Evans rats. Cerebral venous O2 saturations, indicating the balance between local O2 supply and consumption, were found to be significantly more heterogeneous in the sham-operated group. In the anterior cortex, the coefficient of variation [100(SD/mean)] for the sham-operated animals was 22.4%. Sympathectomy significantly reduced this heterogeneity in the anterior cortex through a reduction in the number of low O2 saturation veins (coefficient of variation 11.7%). Blood flow and O2 consumption in the anterior cortex were not different between groups. The effects of sympathectomy in the posterior cortex were similar to those in the anterior cortex. However, sympathectomy did not alter any measured variables in the medulla. Thus, bilateral superior cervical ganglionectomy reduced the heterogeneity of cerebrocortical venous O2 saturation by reducing the number of low O2 saturation veins in the rostral part of the brain.
Journal of Applied Physiology, Vol 74, Issue 4 1911-1915, Copyright © 1993 by American Physiological Society
http://jap.physiology.org/cgi/content/abstract/74/4/1911

Sympathectomy - basal ganglia - functions

In the brain (part of the central nervous system), the "basal ganglia" is a group of nuclei interconnected with the cerebral cortex, thalamus and brainstem, associated with a variety of functions: motor control, cognition, emotions and learning.

The Unbalanced Autonomic Nervous System Causes the Symptoms of the Metabolic Syndrome

The metabolic syndrome consists of visceral obesity, hyperglycemia, hyperinsulinemia, dyslipidemia, and cardiovascular diseases. A common pathophysiological denominator underlying these epidemiological correlations has not been identified. However, the autonomic nervous system was shown to play a role in the metabolic syndrome. Recently, a prospective cohort study in 8,000 patients from 1987-1998 revealed a high relative risk to develop type 2 diabetes if autonomic dysfunction is present in healthy subjects independent from other risk factors, such as body weight.[42]

Diabetes. 2003;52(11):2652-2656. ©2003 American Diabetes Association, Inc.

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