Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis

<b>Background/Objectives</b>: 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 Traum...

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Main Authors: Sean W. Mulvaney, Sanjay Mahadevan, Roosevelt J. Desronvilles, Kyle J. Dineen, Kristine L. Rae Olmsted
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/7/1526
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author Sean W. Mulvaney
Sanjay Mahadevan
Roosevelt J. Desronvilles
Kyle J. Dineen
Kristine L. Rae Olmsted
author_facet Sean W. Mulvaney
Sanjay Mahadevan
Roosevelt J. Desronvilles
Kyle J. Dineen
Kristine L. Rae Olmsted
author_sort Sean W. Mulvaney
collection DOAJ
description <b>Background/Objectives</b>: 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. <b>Methods</b>: 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. <b>Results</b>: 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. <b>Conclusions</b>: 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.
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spelling doaj-art-18b3fe193edd4249a28ab634464bc51a2025-08-20T04:00:54ZengMDPI AGBiomedicines2227-90592025-06-01137152610.3390/biomedicines13071526Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective AnalysisSean W. Mulvaney0Sanjay Mahadevan1Roosevelt J. Desronvilles2Kyle J. Dineen3Kristine L. Rae Olmsted4Department of Military and Emergency Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USAOrthobiologics Research Initiative Inc., 11200 Rockville Pike #230, North Bethesda, MD 20852, USAOrthobiologics Research Initiative Inc., 11200 Rockville Pike #230, North Bethesda, MD 20852, USAOrthobiologics Research Initiative Inc., 11200 Rockville Pike #230, North Bethesda, MD 20852, USARTI International, 3040 E Cornwallis Rd., Research Triangle Park, NC 27709, USA<b>Background/Objectives</b>: 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. <b>Methods</b>: 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. <b>Results</b>: 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. <b>Conclusions</b>: 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.https://www.mdpi.com/2227-9059/13/7/1526stellate ganglion blockTraumatic Brain Injurytwo-level cervical sympathetic chain block2LSCBneurobehavioral symptomsconcussion
spellingShingle Sean W. Mulvaney
Sanjay Mahadevan
Roosevelt J. Desronvilles
Kyle J. Dineen
Kristine L. Rae Olmsted
Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis
Biomedicines
stellate ganglion block
Traumatic Brain Injury
two-level cervical sympathetic chain block
2LSCB
neurobehavioral symptoms
concussion
title Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis
title_full Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis
title_fullStr Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis
title_full_unstemmed Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis
title_short Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks for Traumatic Brain Injury: A Retrospective Analysis
title_sort three month durability of bilateral two level stellate ganglion blocks for traumatic brain injury a retrospective analysis
topic stellate ganglion block
Traumatic Brain Injury
two-level cervical sympathetic chain block
2LSCB
neurobehavioral symptoms
concussion
url https://www.mdpi.com/2227-9059/13/7/1526
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