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Neurosurgical Procedures of the Sympathetic Nervous System

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Neurosurgical Management of Pain

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Abstract

Sympathetically mediated or sympathetically dependent pain encompasses a spectrum of conditions that have in common the factor that the pain can be relieved, at least temporarily, through sympathetic interruption.1–11 The pain may be accompanied by, or may be caused by, dystrophic changes or impaired circulation, but can occur without these physical concomitants and often is accompanied by considerable psychological distress. Sympathetically mediated pain most commonly affects the extremities or causes a specific type of cardiac pain. Diagnostic sympathetic blocks are important not only to determine when pain is sympathetically mediated, but also because one or more sympathetic blocks may provide permanent pain relief. Unfortunately, temporary relief from sympathetic diagnostic blocks does not guarantee permanent relief of the sympathetically mediated pain by sympathectomy, and the sympathectomy may fail to reverse the associated vascular or dystrophic changes. Sympathetically mediated pain states are not uncommon, but are frequently difficult to diagnose or to diagnose with certainty, and their management frequently challenges the skill and perseverance of the clinician.

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Authors
  1. Harold Arthur Wilkinson
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Editors and Affiliations

  1. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Richard B. North MD

  2. Division of Neurological Surgery, Northwestern University Medical School, Chicago, IL, 60611, USA

    Robert M. Levy MD, PhD

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© 1997 Springer Science+Business Media New York

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Wilkinson, H.A. (1997). Neurosurgical Procedures of the Sympathetic Nervous System. In: North, R.B., Levy, R.M. (eds) Neurosurgical Management of Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1938-5_13

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  • DOI: https://doi.org/10.1007/978-1-4612-1938-5_13

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7348-6

  • Online ISBN: 978-1-4612-1938-5

  • eBook Packages: Springer Book Archive

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