Mulvaney Sean W, Mahadevan Sanjay, Desronvilles Roosevelt J, Dineen Kyle J, Rae Olmsted Kristine L
Department of Military and Emergency Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
Orthobiologics Research Initiative Inc., 11200 Rockville Pike #230, North Bethesda, MD 20852, USA.
Biomedicines. 2025 Jun 23;13(7):1526. doi: 10.3390/biomedicines13071526.
: The primary aim of the study was to determine if ultrasound-guided, bilateral, two-level stellate ganglion blocks (SGBs), also known as two-level cervical sympathetic chain blocks (2LCSBs), performed on subsequent days, improve symptoms of chronic mild Traumatic Brain Injury (TBI) over a three-month period, as assessed by the Neurobehavioral Symptom Inventory (NSI). A secondary objective was to evaluate sex-based differences in outcomes during the same time period. : A retrospective chart review was conducted between January 2024 and February 2025. We identified 41 patients who received bilateral 2LCSB for chronic (at least 3 months) TBI-related neurobehavioral symptoms as determined by NSI scores. NSI scores were collected at baseline, one week, one month, two months, and three months post treatment in 28 males and 13 females. An analysis of NSI scores and NSI-composite sub-scores was conducted to determine sex-based differences and 3-month differences in outcomes for patients receiving bilateral 2LCSB. : Of the 41 patients that underwent the bilateral 2LCSB procedure, 35 showed improvement in their NSI scores (85.36%) and 36 reported improvements in NSI sub-scores (87.8%). Across the entire dataset, patients experienced a 48.44% average decrease in total NSI scores from baseline and an average decrease of 43.11% in NSI sub-scores from baseline, indicative of improvements in TBI-specific symptoms. No statistical difference in outcomes was observed between males and females. : Bilateral 2LCSB may provide rapid and durable TBI symptom improvement for 3 months, based on NSI scoring. However, additional research is necessary to establish causality.
本研究的主要目的是确定后续几天进行的超声引导下双侧两级星状神经节阻滞（SGBs），也称为两级颈交感神经链阻滞（2LCSBs），在三个月的时间内是否能改善慢性轻度创伤性脑损伤（TBI）的症状，这通过神经行为症状量表（NSI）进行评估。次要目标是评估同一时期内基于性别的结果差异。
在2024年1月至2025年2月期间进行了一项回顾性病历审查。我们确定了41例因NSI评分确定的慢性（至少3个月）TBI相关神经行为症状而接受双侧2LCSB的患者。在28名男性和13名女性中，于治疗前基线、治疗后1周、1个月、2个月和3个月收集NSI评分。对NSI评分和NSI综合子评分进行分析，以确定接受双侧2LCSB患者基于性别的差异以及3个月时结果的差异。
在接受双侧2LCSB手术的41例患者中，35例NSI评分有所改善（85.36%），36例报告NSI子评分有所改善（87.8%）。在整个数据集中，患者的总NSI评分较基线平均下降了48.44%，NSI子评分较基线平均下降了43.11%，表明TBI特异性症状有所改善。男性和女性在结果上未观察到统计学差异。
基于NSI评分，双侧2LCSB可能在3个月内快速且持久地改善TBI症状。然而，需要进一步的研究来确定因果关系。
