PMID- 33024600 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220417 IS - 2229-5097 (Print) IS - 2152-7806 (Electronic) IS - 2152-7806 (Linking) VI - 11 DP - 2020 TI - Management of CRPS secondary to preganglionic C8 nerve root avulsion: A case report and literature review. PG - 262 LID - 10.25259/SNI_318_2020 [doi] LID - 262 AB - BACKGROUND: Cervical nerve root avulsion is a well-documented result of high-velocity motor vehicle accidents (MVAs). In up to 21% of cases, preganglionic cervical root avulsion can result in a complex regional pain syndrome (CRPS) impacting the quality of life for patients already impaired by motor, sensory, and autonomic dysfunction. The optimal treatment strategies include repeated stellate ganglion blocks (SBGs). CASE DESCRIPTION: A 43-year-old male sustained a high-velocity MVA resulting in the left C8 nerve root avulsion. This resulted in weakness in the C8 distribution, tactile allodynia, and dysesthesias. The magnetic resonance imaging demonstrated an abnormal signal ventral to the C8-T1 level. As the patient was not considered a candidate for surgical intervention secondary to the attendant brachial plexus injury, a C7-C8 epidural steroid injection was performed; this did not provide improvement. Before placing a spinal cord stimulator, the patient underwent a series of six ultrasound-guided SBGs performed 2 weeks apart; there was 75% improvement in pain and strength. Six years later, the patient continues to do well while receiving SBGs 4 times a year. CONCLUSION: A preganglionic cervical nerve root avulsion should not be a contraindication for a stellate ganglion block in a patient with established CRPS. CI - Copyright: (c) 2020 Surgical Neurology International. FAU - Ghaly, Ramsis AU - Ghaly R AD - Department of Anesthesiology, University of Chicago at Illinois, Advocate Illinois Masonic Medical Center, Chicago. AD - Department of Neurosurgery, Ghaly Neurosurgical Associates, Aurora, Illinois, United States. FAU - Haroutunian, Armen AU - Haroutunian A AD - Department of Anesthesiology, University of Chicago at Illinois, Advocate Illinois Masonic Medical Center, Chicago. FAU - Grigoryan, Gevorg AU - Grigoryan G AD - Department of Anesthesiology, University of Chicago at Illinois, Advocate Illinois Masonic Medical Center, Chicago. FAU - Patricoski, Jessica A AU - Patricoski JA AD - Department of Neurosurgery, Ghaly Neurosurgical Associates, Aurora, Illinois, United States. FAU - Candido, Kenneth D AU - Candido KD AD - Department of Anesthesiology, University of Chicago at Illinois, Advocate Illinois Masonic Medical Center, Chicago. FAU - Knezevic, Nebojsa Nick AU - Knezevic NN AD - Department of Anesthesiology, University of Chicago at Illinois, Advocate Illinois Masonic Medical Center, Chicago. LA - eng PT - Case Reports DEP - 20200829 PL - United States TA - Surg Neurol Int JT - Surgical neurology international JID - 101535836 PMC - PMC7533089 OTO - NOTNLM OT - Avulsion OT - Cervical OT - Complex regional pain syndrome OT - Nerve root OT - Preganglionic OT - Stellate ganglion block COIS- There are no conflicts of interest. EDAT- 2020/10/08 06:00 MHDA- 2020/10/08 06:01 PMCR- 2020/08/29 CRDT- 2020/10/07 05:50 PHST- 2020/05/28 00:00 [received] PHST- 2020/08/06 00:00 [accepted] PHST- 2020/10/07 05:50 [entrez] PHST- 2020/10/08 06:00 [pubmed] PHST- 2020/10/08 06:01 [medline] PHST- 2020/08/29 00:00 [pmc-release] AID - SNI-11-262 [pii] AID - 10.25259/SNI_318_2020 [doi] PST - epublish SO - Surg Neurol Int. 2020 Aug 29;11:262. doi: 10.25259/SNI_318_2020. eCollection 2020.