Cerebral blood flow rose, while vascular resistance did not change after cervical sympathectomy

After bilateral cervical sympathectomy (n = 9), carotid chemoreceptor reflex stimulation induced significantly different (P less than 0.01) effects on cerebral blood flow, which rose by 42 +/- 8%, and cerebral vascular resistance, which did not change.

To determine whether the difference in effect was due to the sympathectomy or merely to the repetition of the stimulus, another group of dogs (sham; n = 6) that had intact sympathetic nerves were studied a second time. In "sham" dogs, the repeat response to carotid chemoreceptor stimulation also induced significantly different effects from those in dogs with sympathectomy.

Am J Physiol Heart Circ Physiol 238: H594-H598, 1980;
http://ajpheart.physiology.org/cgi/content/abstract/238/4/H594

Melatonin levels markedly reduced after sympathectomy

In the patient with hyperhidrosis, a prominent melatonin rhythm was observed preoperatively in the CSF and plasma. After bilateral T1-T2 ganglionectomy, however, melatonin levels were markedly reduced, and the diurnal rhythm was abolished. These results provide direct evidence in humans for a diurnal melatonin rhythm in CSF and plasma as well as regulation of this rhythm by sympathetic innervation.

J Clin Endocrinol Metab 72: 819–823, 1991

Sympathectomy-induced changes on the ventricular surface

Various investigators have shown that unilateral ganglionectomy or transection of the internal and external carotid nerves leads to a regenerative response in the ipsilateral superior cervical ganglion and to uninjured mature sympathetic neurons sprouting into bilaterally innervated shared target organs. In this study changes in the supraependymal neuronal network following unilateral and bilateral cervical sympathectomy on the infundibular floor of the third ventricle were studied by scanning electron microscopy in comparison with normal and sham-operated control animals. After unilateral cervical sympathectomy there was a great increase in the number of varicose nerve fibres on the infundibular floor as compared to the normal and sham-operated control animals. Not only was there an increase in the number of nerve fibres, but also their varicosities were substantially larger than those normally present on the ependymal surface. This study indicates the possible sympathetic projections from the superior cervical ganglia to the ependymal surface of the third cerebral ventricle.

http://www.ncbi.nlm.nih.gov/pubmed/17594665

Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis :

Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis : preliminary results

Journal of neurosurgery ISSN 0022-3085

1999, vol. 90, no3, pp. 463-467 (38 ref.)

Postsympathectomy syndrome

Postsympathectomy limb pain, postsympathectomy parotid pain, and Raeder's paratrigeminal syndrome are pain states associated with the loss of sympathetic fibres and in particular with postganglionic sympathetic lesions. There is a characteristic interval of about 10 days between surgical sympathectomy and onset of pain. It is proposed that this pain in man is correlated with the delayed rise in sensory neuropeptides seen in rodents after sympathectomy. These chemical changes probably reflect the sprouting of sensory fibres and may result from the greater availability of nerve growth factor after sympathectomy. The balance between the sensory and sympathetic innervations of a peripheral organ may be determined by competition for a limited supply of nerve growth factor.

Lancet. 1985 Nov 23;2(8465):1158-60.

http://www.ncbi.nlm.nih.gov/pubmed/2414615

bilateral ETS causes the suppression of cardiovascular response to exercise

HR and BP at rest and cardiovascular response to exercise were similar in patients with palmar hyperhidrosis before ETS and in the normal control population. Therefore, we consider that patients with palmar hyperhidrosis have no overactivity of the sympathetic nerve. However, because bilateral ETS causes the suppression of cardiovascular response to exercise, patients that has been treated with ETS need to be observed during high-level exercise.

http://iars.org/abstracts/browsefile/browse.asp?command=N&absnum=45&dir=S190

Chest wall paresthesia affects a significant but previously overlooked proportion of patients

The rates and characteristics of the paresthesia following needlescopic VATS are similar to those observed after conventional VATS. CONCLUSIONS: Chest wall paresthesia affects a significant but previously overlooked proportion of patients following needlescopic VATS, but has minimal impact on post-operative satisfaction. Needlescopic VATS offers no apparent advantage over conventional VATS with regard to paresthesia.

http://www.ncbi.nlm.nih.gov/pubmed/15691688?dopt=Abstract

supersensitivity to sympathomimetic amines in the chronically denervated heart

http://www.ncbi.nlm.nih.gov/pubmed/2988820?dopt=Abstract

The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer

NPY, NPY receptors and DPPIV in innate immunity and autoimmune disorders

Book	The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer
Publisher	Birkhäuser Basel
DOI	10.1007/3-7643-7427-6
Copyright	2005
ISBN	978-3-7643-7159-3 (Print) 978-3-7643-7427-3 (Online) page 71: Lewis rats are much more likely to develop autoimmune disorders after sympathectomy (Dimitrova and Felten, 1995). This finding suggests that if sympathetic regulation were impaired in a genetically predisposed individual, an autoimmune disease might develop. Betrayal by the Brain: The Neurologic Basis of Chronic Fatigue Syndrome, Fibromyalgia Syndrome and Related Neural Network Disorders by Jay A. Goldstein published by The Haworth Medical Press, 1996

spontaneous vasospasm 10 days after sympathectomy

We have observed spontaneous vasospasm in the hands on emotional disturbances within ten days after sympathectomy, but no clinical evidence of this in the feet. I believe that sensitization of the denervated smooth muscle in the digital arterioles to adrenine is a better explanation of this phenomenon than local sensitivity to cold (Lewis, 1930), incomplete sympathectomy (Adson, and Leriche and Fontaine, 1933), or the common argument that Raynaud's disease is moresevere in the hands than in the feet.
PROCEEDINGS OF THE TWENTY-SEVENTH ANNUAL MEETING OF THE
AMERICAN SOCIETY FOR CLINICAL INVESTIGATION
HELD IN ATLANTIC CITY, N. J., MAY 6, 1935

Effect of Sympathectomy on Blood Flow

These experimental hemodynamic considerations, in general, explain the occasional untoward effects of sympathectomy, and provide support for some of the empirically derived indications and contra-in- dications for sympathectomy.
Sympathectomy should be tailored to denervate only the ischemic area, if this is possible. Sympathectomy should not be performed where collateral channels do not exist, because of the danger of flow shifts. Sympathectomy probably should not be employed for relief of intermittent claudication.
Annals of Surgery August 1963

Reduced resistances of septal artery collateral channels after cardiac sympathectomy

Journal	Basic Research in Cardiology
Publisher	Steinkopff
ISSN	0300-8428 (Print) 1435-1803 (Online)
Issue	Volume 78, Number 4 / July, 1983

No increase in muscle blood flow following sympathectomy

Recent evidence suggests that this increase in total blood flow represents, in the main, arteriovenous shunting with little, if any, effect on the nutritive blood flow at the tissue level. Studies aimed at investigating the effect of lumbar sympathectomy on regional tissue circulation have utilized the local clearance of radioactive isotopes. No significant change in the clearance of these substances in muscle have been noted following lumbar sympathectomy in man. However, the data on skin clearance remains conflicting.
Vascular and Endovascular Surgery, Vol. 6, No. 5, 227-238 (1972)
http://ves.sagepub.com/cgi/pdf_extract/6/5/227

Imbalance of regional cerebral blood flow and oxygen consumption: effect of vascular alpha adrenoceptor blockade

Cerebral venous O2 saturations (a measure of cerebral O2 supply/consumption balance) were found to be significantly heterogeneous under control conditions. The coefficient of variation (CV = 100 x SD/mean) averaged 18%. The average cerebral venous O2 saturation was 59 +/- 11%. Administration of N-methyl chlorpromazine significantly reduced this heterogeneity through a reduction in the number of veins with low O2 saturations (CV = 11%). The average value increased slightly but significantly to 62 +/- 8%. Thus, N-methyl chlorpromazine eliminated many microregions of high O2 extraction. This indicated that vascular alpha adrenoceptors limit cerebral blood flow to some of the brain regions.
Neuropharmacology. 1993 Mar;32(3):297-302.

Long-term cardiopulmonary function after thoracic sympathectomy

Lung function tests revealed a significant decrease in forced expiratory volume in 1 second (FEV₁) and forced expiratory flow between 25% and 75% of vital capacity (FEF_25%–75%) in both groups (FEV₁ of –6.3% and FEF_25%–75% of –9.1% in the conventional thoracic sympathectomy group and FEV₁ of –3.5% and FEF_25%–75% of –12.3% in the simplified thoracic sympathectomy group). DLCO and heart rate at rest and maximal values after exercise were also significantly reduced in both groups (DLCO of –4.2%, DLCO corrected by alveolar volume of –6.1%, resting heart rate of –11.8 beats/min, and maximal heart rate of –9.5 beats/min in the conventional thoracic sympathectomy group and DLCO of –3.9%, DLCO corrected by alveolar volume of –5.2%, resting heart rate of –10.7 beats/min, and maximal heart rate of –17.6 beats/min in the simplified thoracic sympathectomy group). Airway resistance increased significantly in the group of patients undergoing conventional thoracic sympathectomy (+13%).
No significant differences were found between the conventional and simplified thoracic sympathectomy groups.
J Thorac Cardiovasc Surg 2010;139:405-410

The cerebral vessels became hypersensitive to epinephrine after cervical sympathectomy

The cerebral vessels became hypersensitive to epinephrine after cervical sympathectomy.
HERTZMAN, A. B., AND DILLON, J. B.
Annual Review of Physiology
Vol. 4: 187-214 (Volume publication date March 1942)