Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage

Cerebral vasospasm is a major complication after subarachnoid hemorrhage (SAH) and is an important factor leading to disability and mortality in patients. Cerebral vasospasm involves cerebral artery stenosis and leads to delayed cerebral ischemia, further exacerbating brain damage. The pathophysiolo...

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Main Authors: Zhaoquan Wang, Jianqiang Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1571550/full
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author Zhaoquan Wang
Jianqiang Li
author_facet Zhaoquan Wang
Jianqiang Li
author_sort Zhaoquan Wang
collection DOAJ
description Cerebral vasospasm is a major complication after subarachnoid hemorrhage (SAH) and is an important factor leading to disability and mortality in patients. Cerebral vasospasm involves cerebral artery stenosis and leads to delayed cerebral ischemia, further exacerbating brain damage. The pathophysiology of cerebral vasospasm is multifactorial, involving a complex interaction between fragmented red blood cell metabolism, endothelial dysfunction, and hyperresponsive contraction of smooth muscle cells. Recent studies have highlighted the important role of the sympathetic nervous system (SNS) in mediating and exacerbating cerebral vasospasm. Sympathetic activation affects vascular tone and contributes to the development of vasospasm after SAH. Stellate ganglion block (SGB) has been reported to have a protective effect in patients at risk for vasospasm after SAH due to reduced sympathetic activity. This review aims to explore the current understanding of the relationship between sympathetic activity and cerebral vasospasm, investigate the molecular mechanisms involved, clinical implications, and potential therapeutic strategies targeting sympathetic modulation.
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spelling doaj-art-caf41a2a1a1f44f5a4f19372a539a5e72025-08-20T03:26:16ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15715501571550Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhageZhaoquan WangJianqiang LiCerebral vasospasm is a major complication after subarachnoid hemorrhage (SAH) and is an important factor leading to disability and mortality in patients. Cerebral vasospasm involves cerebral artery stenosis and leads to delayed cerebral ischemia, further exacerbating brain damage. The pathophysiology of cerebral vasospasm is multifactorial, involving a complex interaction between fragmented red blood cell metabolism, endothelial dysfunction, and hyperresponsive contraction of smooth muscle cells. Recent studies have highlighted the important role of the sympathetic nervous system (SNS) in mediating and exacerbating cerebral vasospasm. Sympathetic activation affects vascular tone and contributes to the development of vasospasm after SAH. Stellate ganglion block (SGB) has been reported to have a protective effect in patients at risk for vasospasm after SAH due to reduced sympathetic activity. This review aims to explore the current understanding of the relationship between sympathetic activity and cerebral vasospasm, investigate the molecular mechanisms involved, clinical implications, and potential therapeutic strategies targeting sympathetic modulation.https://www.frontiersin.org/articles/10.3389/fneur.2025.1571550/fullcerebral vasospasmsubarachnoid hemorrhagesympathetic nervous systemstellate ganglion blockROS
spellingShingle Zhaoquan Wang
Jianqiang Li
Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
Frontiers in Neurology
cerebral vasospasm
subarachnoid hemorrhage
sympathetic nervous system
stellate ganglion block
ROS
title Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
title_full Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
title_fullStr Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
title_full_unstemmed Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
title_short Sympathetic nerve block as an add-on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
title_sort sympathetic nerve block as an add on therapy for intervention and prevention of cerebral vasospasm after subarachnoid hemorrhage
topic cerebral vasospasm
subarachnoid hemorrhage
sympathetic nervous system
stellate ganglion block
ROS
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1571550/full
work_keys_str_mv AT zhaoquanwang sympatheticnerveblockasanaddontherapyforinterventionandpreventionofcerebralvasospasmaftersubarachnoidhemorrhage
AT jianqiangli sympatheticnerveblockasanaddontherapyforinterventionandpreventionofcerebralvasospasmaftersubarachnoidhemorrhage