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, November 26, 2009

Renin-Angiotensin activation following sympathectomy

"After sympathectomy, BP is maintained at nearly normal levels mainly through activation of the renin angiotensin system. (Heart and Circulatory Physiology, Vol 259, Issue 5 1337-H1342, Copyright © 1990 by American Physiological Society).

We should note that baroreflex response for maintaining cardiovascular stability is
suppressed in the patients who received the ETS.
Anesthesiology 2001; 95:A160

“cervical sympathectomy isolates all these sympathetic ganglion cells from the central nervous system and prevents them from responding to reflex or emotional changes in the central nervous system." Cunningham's Manual of Practical Anatomy: Volume III: Head, Neck and Brain, 1986

The renin-angiotensin system (RAS) is a major regulatory system of cardiovascular and renal function. Many new aspects of this system have been revealed in recent years, leading to new therapeutic approaches. It's well known that RAS blocking agents have potent antiatherosclerotic effects, which are mediated by their antihypertensive, anti-inflammatory, antiproliferative, and oxidative stress lowering properties. Inhibitors of RAS are now first-line treatments for hypertensive target organ damage. Their effects are greater than expected by their ability to lower blood pressure. Angiotensin receptor blockers reduce the frequency of atrial fibrillation and stroke, are also able to prevent cardiovascular and renal events in diabetic patients. Thus, blockade of RAS represents one of the most important strategies in order to reduce cardiovascular risk.

Neurol Sci. 2008 Sep;29 Suppl 2:S277-8.

Renin-angiotensin system and stroke.

Marcheselli S, Micieli G.