-
Anatomical Record (Hoboken, N.J. : 2007) Nov 2018Wheat germ agglutinin-horseradish peroxidase was injected into the entire (0.8 μL) or partial (rostral or caudal, 0.1-0.3 μL) superior cervical ganglion (SCG) of the...
Wheat germ agglutinin-horseradish peroxidase was injected into the entire (0.8 μL) or partial (rostral or caudal, 0.1-0.3 μL) superior cervical ganglion (SCG) of the rat (male Sprague-Dawley, N = 35) to examine the distribution of neurons in the middle (MCG) and inferior (ICG) cervical ganglion that send axons bypass the SCG. Whole-mounts of the SCG, cervical sympathetic trunk (CST), MCG, ICG, and sections of the brainstem and spinal cord were prepared. With entire SCG tracer injection, neurons were labeled evenly in the MCG (left: 258, right: 121), ICG (left: 848, right: 681), and CST (up to 770). Some neurons grouped in a single bulge just rostral to the MCG, which we termed as the "premiddle cervical ganglion" (pMCG). The left pMCG (120) is larger and has more neurons than the right pMCG (82). Centrally, neurons were labeled in lamina IX of cervical segments (C1: 18%, C2: 46%, C3: 33%, C4: 3%), intermediate zone of thoracic segments (T1: 31%, T2: 35%, T3: 27%, T4: 7%), and intermediate reticular nuclei (96%) and perifacial zone (4%) of brainstem. The rostral and caudal SCG injection selectively labeled neurons mainly in brainstem, C1-C2 and in T1-T2, respectively. Before projecting to their peripheral targets, many neurons in pMCG, MCG and ICG run rostrally within the CST rather than segmentally through the closest rami, from the level of SCG or above. Neurons in pMCG and MCG may have similar or complementary function and those in brainstem may be involved in the vestibulo-autonomic interaction. Anat Rec, 301:1906-1916, 2018. © 2018 Wiley Periodicals, Inc.
Topics: Animals; Axons; Brain Stem; Male; Rats; Rats, Sprague-Dawley; Spinal Cord; Superior Cervical Ganglion
PubMed: 30338669
DOI: 10.1002/ar.23953 -
Current Pain and Headache Reports Dec 2021In this narrative review, the current literature on neurostimulation methods in the treatment of chronic cluster headache is evaluated. These neurostimulation methods... (Review)
Review
PURPOSE OF REVIEW
In this narrative review, the current literature on neurostimulation methods in the treatment of chronic cluster headache is evaluated. These neurostimulation methods include deep brain stimulation, vagus nerve stimulation, greater occipital nerve stimulation, sphenopalatine ganglion stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, supraorbital nerve stimulation, and cervical spinal cord stimulation.
RECENT FINDINGS
Altogether, only nVNS and SPG stimulation are supported by at least one positive sham-controlled clinical trial for preventive and acute attack (only SPG stimulation) treatment. Other clinical trials either did not control at all or controlled by differences in the stimulation technique itself but not by a sham-control. Case series report higher responder rates. The evidence for these neurostimulation methods in the treatment of chronic cluster headache is poor and in part contradictive. However, except deep brain stimulation, tolerability and safety of these methods are good so that in refractory situations application might be justified in individual cases.
Topics: Cluster Headache; Ganglia, Parasympathetic; Humans; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation; Vagus Nerve Stimulation
PubMed: 34894300
DOI: 10.1007/s11916-021-00989-6 -
Pain Physician Jan 2018Understanding the characteristics of the middle cervical sympathetic ganglion (MCSG) may minimize procedure-related complications and maximize efficacy during surgery or... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Understanding the characteristics of the middle cervical sympathetic ganglion (MCSG) may minimize procedure-related complications and maximize efficacy during surgery or ultrasound (US)-guided procedures. The location and detection rate of the MCSG were variable in small population studies. Therefore, a large population study or meta-analysis could give more information about the MCSG.
OBJECTIVES
We aim to review the published literature and evaluate the anatomical features of the MCSG, including the detection rate, location, size, and a normal variation, and to review the clinical relevance of MCSG for procedures including, US-guided ganglion block, ethanol ablation (EA), or radiofrequency ablation (RFA).
STUDY DESIGN
A systematic review and meta-analysis. The Ovid-MEDLINE and EMBASE databases were searched to find the detection rate, location, and other characteristics of the MCSG.
SETTING
The pooled proportions for the detection rate of the MCSG were assessed using the DerSimonian-Laird random-effects model.
METHODS
Heterogeneity among the studies was determined using a chi-square analysis for the pooled estimates and inconsistency index (I²). In order to reduce the heterogeneity, sensitivity analyses were performed.
RESULTS
A review of 542 studies identified 8 eligible studies, with 273 MCSGs included in the meta-analysis. The pooled proportion for the detection rate of the MCSG was 50.4% (95% confidence interval [CI], 34.5 - 66.4%). Considerable heterogeneity among the studies was observed (I² = 94.9%). In the sensitivity analysis, when excluding one study, heterogeneity was reduced with a recalculated pooled proportion of 44.2% (95% CI, 32.1 - 56.2%; I² = 86.0%). The location of the MCSG is usually posterior to the carotid sheath and anterior to the longus colli muscle at the level of the C3 - C7 vertebrae. There was a variant where the cervical sympathetic trunk was located at the posterior wall of the carotid sheath and was adherent to the sheath. The size of the MCSG is as follows: the width, length, and height ranges were 3.8 - 6.3 mm, 6.3 - 10.5 mm, and 1.7 - 2.1 mm, respectively. A specific type of MCSG, referred to as the "double middle cervical ganglion", consisting of 2 ganglia, was demonstrated in 3 studies with a detection rate of 2.9 - 10%.
LIMITATIONS
This meta-analysis included a relatively small number of studies. Significant heterogeneity was also present in the detection rate of MCSG in these studies. There was a lack of concentrated information about the MCSG, because the majority of the included studies focused on the entire cervical sympathetic chain, not only MCSG primarily. Improving complication rates might be limited due to the approximate 50% detection rate.
CONCLUSION
Understanding the characteristics and variations of the MCSG could minimize complications and maximize efficacy during surgery and US-guided procedures.
KEY WORDS
Middle cervical sympathetic ganglion, cervical sympathetic trunk, cervical sympathetic chain, ultrasound, nerve block, ethanol ablation, radiofrequency ablation, thyroid, Horner syndrome, meta-analysis.
Topics: Cervical Vertebrae; Ganglia, Sympathetic; Humans
PubMed: 29357327
DOI: No ID Found -
Korean Journal of Radiology 2017The neck has intricately connected neural structures, including cervical and brachial plexi, the sympathetic system, lower cranial nerves, and their branches. Except for... (Review)
Review
The neck has intricately connected neural structures, including cervical and brachial plexi, the sympathetic system, lower cranial nerves, and their branches. Except for brachial plexus, there has been little research regarding the normal imaging appearance or corresponding pathologies of neural structures in the neck. The development in imaging techniques with better spatial resolution and signal-to-noise ratio has made it possible to see many tiny nerves to predict complications related to image-guided procedures and to better assess treatment response, especially in the management of oncology patients. The purposes of this review is to present imaging-based anatomy of major nerves in the neck and explain their relevant clinical significance according to representative pathologies of regarded nerves in the neck.
Topics: Brachial Plexus; Cervical Plexus; Humans; Magnetic Resonance Imaging; Neck; Signal-To-Noise Ratio; Vagus Nerve
PubMed: 28096728
DOI: 10.3348/kjr.2017.18.1.180 -
Ear, Nose, & Throat Journal Dec 2023Ganglioneuroma is a rare benign tumor originating in the sympathetic ganglia, composed of differentiated ganglion cells, nerve sheath cells, and nerve fibers, which tend... (Review)
Review
Ganglioneuroma is a rare benign tumor originating in the sympathetic ganglia, composed of differentiated ganglion cells, nerve sheath cells, and nerve fibers, which tend to occur in the posterior mediastinum, adrenal gland, retroperitoneal, and other locations, occurring in the head and neck is relatively rare, and parapharyngeal space involvement is extremely rare. In our report, we present 2 adult male patients whose preoperative imaging and fine needle cytology did not confirm the diagnosis of a parapharyngeal space mass and who completely resected the tumor through a combined cervical and oral approach. Finally, pathology confirmed ganglioneuroma; we also reviewed the English articles on parapharyngeal ganglioneuroma over the past 40 years, and summarized the diagnostic and treatment characteristics of parapharyngeal ganglioneuroma in combination with our cases to improve understanding of the disease.
Topics: Adult; Humans; Male; Parapharyngeal Space; Ganglioneuroma; Neck; Needles
PubMed: 36450599
DOI: 10.1177/01455613221142658 -
International Journal of Molecular... Nov 2022Heart failure (HF) is a major public health problem worldwide, especially coronary heart disease (myocardial infarction)-induced HF with reduced ejection fraction... (Review)
Review
Heart failure (HF) is a major public health problem worldwide, especially coronary heart disease (myocardial infarction)-induced HF with reduced ejection fraction (HFrEF), which accounts for over 50% of all HF cases. An estimated 6 million American adults have HF. As a major feature of HF, cardiac sympathetic overactivation triggers arrhythmias and sudden cardiac death, which accounts for nearly 50-60% of mortality in HF patients. Regulation of cardiac sympathetic activation is highly integrated by the regulatory circuitry at multiple levels, including afferent, central, and efferent components of the sympathetic nervous system. Much evidence, from other investigators and us, has confirmed the afferent and central neural mechanisms causing sympathoexcitation in HF. The stellate ganglion is a peripheral sympathetic ganglion formed by the fusion of the 7th cervical and 1st thoracic sympathetic ganglion. As the efferent component of the sympathetic nervous system, cardiac postganglionic sympathetic neurons located in stellate ganglia provide local neural coordination independent of higher brain centers. Structural and functional impairments of cardiac postganglionic sympathetic neurons can be involved in cardiac sympathetic overactivation in HF because normally, many effects of the cardiac sympathetic nervous system on cardiac function are mediated via neurotransmitters (e.g., norepinephrine) released from cardiac postganglionic sympathetic neurons innervating the heart. This review provides an overview of cardiac sympathetic remodeling in stellate ganglia and potential mechanisms and the role of cardiac sympathetic remodeling in cardiac sympathetic overactivation and arrhythmias in HF. Targeting cardiac sympathetic remodeling in stellate ganglia could be a therapeutic strategy against malignant cardiac arrhythmias in HF.
Topics: Humans; Stellate Ganglion; Heart Failure; Stroke Volume; Heart; Sympathetic Nervous System; Arrhythmias, Cardiac
PubMed: 36362099
DOI: 10.3390/ijms232113311 -
AJNR. American Journal of Neuroradiology Aug 2022Intraosseous venous malformations represent a subtype of venous vascular malformations that arise primarily in bone. In the head and neck, intraosseous venous... (Review)
Review
Intraosseous venous malformations represent a subtype of venous vascular malformations that arise primarily in bone. In the head and neck, intraosseous venous malformations are most frequently found in the skull, skull base, and facial skeleton, with location at the geniculate ganglion of the facial nerve perhaps the most widely recognized. These non-neoplastic lesions are characterized by dilated venous channels with characteristic internal bony spicules on CT but may present with a more complex appearance on MR imaging and may share features with more aggressive lesions. Further confounding the imaging-based diagnosis of intraosseous venous malformation is the frequent misrepresentation of these lesions as hemangiomas in the radiology and clinical literature, as well as in daily practice. Because most intraosseous venous malformations can be left alone, their correct diagnosis may spare a patient unnecessary concern and intervention.
Topics: Humans; Tomography, X-Ray Computed; Vascular Malformations; Head; Skull; Neck
PubMed: 35863785
DOI: 10.3174/ajnr.A7575 -
British Journal of Pharmacology and... Dec 1959The actions of 1,1-dimethyl-4-phenylpiperazinium iodide (DMPP) have been studied to discover under what conditions a blocking action could be seen....
The actions of 1,1-dimethyl-4-phenylpiperazinium iodide (DMPP) have been studied to discover under what conditions a blocking action could be seen. Dimethylphenylpiperazinium has a stimulant action on autonomic ganglia, stimulating the superior cervical ganglion and causing contraction of the nictitating membrane. It caused slowing followed by acceleration of the rate of beat of isolated rabbit atria. The denervated gastrocnemius muscle contracted if dimethylphenylpiperazinium was injected intra-arterially. Under other circumstances a blocking action was seen. It blocked peristalsis in the isolated guinea-pig ileum stimulated by raising intraluminal pressure and inhibited the response of the rat diaphragm and of the cat gastrocnemius stimulated through the motor nerve. It is suggested that dimethylphenylpiperazinium acts by depolarization, causing stimulation of resting muscle but inhibition by prolonging depolarization.
Topics: Animals; Cats; Dimethylphenylpiperazinium Iodide; Ganglia, Autonomic; Guinea Pigs; Ileum; Nictitating Membrane; Piperazines; Rabbits; Rats
PubMed: 14417244
DOI: 10.1111/j.1476-5381.1959.tb00957.x -
Turkish Neurosurgery 2023To evaluate the efficacy and safety of combined transforaminal anterior epidural steroid injection (TAESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF)...
AIM
To evaluate the efficacy and safety of combined transforaminal anterior epidural steroid injection (TAESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) therapy on the radicular neck pain.
MATERIAL AND METHODS
The results of 84 patients with cervical radicular pain who underwent combined DRG-PRF and TAESI under fluoroscopy were evaluated retrospectively. Primer outcome is the pain measurements of the patients before and after the procedure at the 1 < sup > st < /sup > , 3 < sup > rd < /sup > , and 6 < sup > th < /sup > months were evaluated with the Verbal Pain Scale (VPS). Our secondary outcome was the evaluation of patient satisfaction in the 1 < sup > st < /sup > , 3 < sup > rd < /sup > , and 6 < sup > th < /sup > months after the interventional treatment, and it was considered significant if it was evaluated as ?good? above 50%.
RESULTS
We found statistically significant decrease in the pain scores of the patients in the 1 < sup > st < /sup > , 3 < sup > rd < /sup > , and 6 < sup > th < /sup > months compared to the pre-intervention (VPS 0) (p < 0.001). After the procedure, the patients expressed their satisfaction level as 69.1% at the 1 < sup > st < /sup > month, 71.5% at the 3 < sup > rd < /sup > month, and 72.6% at the 6th month as ?very good/good?. While the operation was mostly performed at the C5-6 level on both sides, it was seen that 61.9% of the operations were applied from the right side and 38.1% from the left side. No adverse effects or fatal neurological complications were observed.
CONCLUSION
Although the efficacy and complications of cervical TAESI and DRG-PRF treatment are controversial in the literature, we think that this combined treatment can provide effective pain palliation in experienced hands with appropriate patient selection, considering the risk / benefit ratio.
Topics: Humans; Neck Pain; Ganglia, Spinal; Pulsed Radiofrequency Treatment; Retrospective Studies; Treatment Outcome; Steroids
PubMed: 35929031
DOI: 10.5137/1019-5149.JTN.36295-21.3 -
AJNR. American Journal of Neuroradiology Jan 2018The superior cervical ganglion and inferior ganglion of the vagus nerve can mimic pathologic retropharyngeal lymph nodes. We studied the cross-sectional anatomy of the...
BACKGROUND AND PURPOSE
The superior cervical ganglion and inferior ganglion of the vagus nerve can mimic pathologic retropharyngeal lymph nodes. We studied the cross-sectional anatomy of the superior cervical ganglion and inferior ganglion of the vagus nerve to evaluate how they can be differentiated from the retropharyngeal lymph nodes.
MATERIALS AND METHODS
This retrospective study consists of 2 parts. Cohort 1 concerned the signal intensity of routine neck MR imaging with 2D sequences, apparent diffusion coefficient, and contrast enhancement of the superior cervical ganglion compared with lymph nodes with or without metastasis in 30 patients. Cohort 2 used 3D neurography to assess the morphology and spatial relationships of the superior cervical ganglion, inferior ganglion of the vagus nerve, and the retropharyngeal lymph nodes in 50 other patients.
RESULTS
All superior cervical ganglions had homogeneously greater enhancement and lower signal on diffusion-weighted imaging than lymph nodes. Apparent diffusion coefficient values of the superior cervical ganglion (1.80 ± 0.28 × 10mm/s) were significantly higher than normal and metastatic lymph nodes (0.86 ± 0.10 × 10mm/s, < .001, and 0.73 ± 0.10 × 10mm/s, < .001). Ten and 13 of 60 superior cervical ganglions were hypointense on T2-weighted images and had hyperintense spots on both T1- and T2-weighted images, respectively. The latter was considered fat tissue. The largest was the superior cervical ganglion, followed in order by the retropharyngeal lymph node and the inferior ganglion of the vagus nerve ( < .001 to = .004). The highest at vertebral level was the retropharyngeal lymph nodes, followed, in order, by the inferior ganglion of the vagus nerve and the superior cervical ganglion ( < .001 to = .001). The retropharyngeal lymph node, superior cervical ganglion, and inferior ganglion of the vagus nerve formed a line from anteromedial to posterolateral.
CONCLUSIONS
The superior cervical ganglion and the inferior ganglion of the vagus nerve can be almost always differentiated from retropharyngeal lymph nodes on MR imaging by evaluating the signal, size, and position.
Topics: Adult; Aged; Cross-Sectional Studies; Diffusion Magnetic Resonance Imaging; Female; Humans; Lymph Nodes; Male; Middle Aged; Retrospective Studies; Superior Cervical Ganglion; Vagus Nerve
PubMed: 29122764
DOI: 10.3174/ajnr.A5434