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05 January 2025 : Case report  China

[In Press] Management of Post-Stroke Cold Sensations: A Case Study on Sympathetic Nerve Ablation

Unusual clinical course, Unusual or unexpected effect of treatment

Haojia Li1ACG, Dejian Chen1AF, Jiajia Deng1BF, Lu Sun2CD, Jianjun Zhu1EF, Hanrui Fan ORCID logo1BC, Yingjie Hua3CF, Xiaoyan Guo4BD, Ming Yao1AEF, Yong Fei1AEG

DOI: 10.12659/AJCR.946352

Am J Case Rep In Press; DOI: 10.12659/AJCR.946352  

Available online: 2025-01-05, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

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.

Keywords: Ablation Techniques; Cold Temperature; Peripheral Arterial Disease; Stroke

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923