Management of Post-Stroke Cold Sensations: A Case Study on Sympathetic Nerve Ablation.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Haojia Li, Dejian Chen, Jiajia Deng, Lu Sun, Jianjun Zhu, Hanrui Fan, Yingjie Hua, Xiaoyan Guo, Ming Yao, Yong Fei
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Abstract

BACKGROUND Stroke is a leading cause of mortality worldwide and often results in complex sequelae. Peripheral circulation disorders in paralyzed limbs are particularly challenging, presenting as persistent cold sensations and cold-induced pain that severely impair patients' quality of life. This report presents an innovative approach to managing refractory post-stroke limb coldness and pain using computed tomography (CT)-guided sympathetic nerve radiofrequency ablation. CASE REPORT We present the case of a 65-year-old woman with hemiplegia in her left extremities following a cerebral infarction 1 year earlier. Despite standardized treatment, her condition worsened after 6 months, with increased spasticity, cold-induced pain, and a significant drop in temperature in the left limbs. To address these issues, CT-guided radiofrequency ablation of the sympathetic nerve at the fourth thoracic vertebra and the third lumbar vertebral body was performed at 75°C for 3 min. The procedure significantly improved the peripheral perfusion index, increased palm and foot temperature, and reduced pain. Magnetic resonance imaging revealed improved cerebral infarction and enhanced brain function in temperature-related regions. Ethical approval and patient consent for publication were obtained. CONCLUSIONS CT-guided radiofrequency ablation of the thoracic and lumbar sympathetic nerves effectively alleviates post-stroke peripheral circulation disorders, improves limb temperature, and enhances collateral circulation. This report underscores the importance of awareness and early intervention for such post-stroke complications in patients.

脑卒中后冷感的处理:交感神经消融的个案研究。
背景:中风是世界范围内导致死亡的主要原因之一,通常会导致复杂的后遗症。瘫痪肢体的外周循环障碍尤其具有挑战性,表现为持续的冷感和冷引起的疼痛,严重损害患者的生活质量。本报告介绍了一种利用计算机断层扫描(CT)引导的交感神经射频消融治疗难治性卒中后肢体寒冷和疼痛的创新方法。病例报告我们提出的情况下,65岁的妇女偏瘫在她的左四肢脑梗死1年前。尽管进行了标准化治疗,但她的病情在6个月后恶化,痉挛加剧,寒冷引起的疼痛,左四肢体温明显下降。为了解决这些问题,在ct引导下,在75°C下对第四胸椎和第三腰椎的交感神经进行射频消融术,持续3分钟。该手术显著改善了周围灌注指数,增加了手掌和足部温度,减轻了疼痛。磁共振成像显示脑梗死改善和脑功能增强在温度相关区域。获得了发表的伦理批准和患者同意。结论ct引导下射频消融胸腰椎交感神经可有效缓解脑卒中后外周血循环障碍,改善肢体温度,增强侧支循环。该报告强调了对患者卒中后并发症的认识和早期干预的重要性。
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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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