Jugular ganglia

A 28-year-old 75 kg woman underwent stellate ganglion block for symptomatic treatment of Raynaud s syndrome. An anterolateral approach was used, guarding the carotid artery and jugular vein. After an aspiration test was negative in two planes, 5 ml of 1% lidocaine was injected over 2-3 seconds using a 20 G needle. However, a second aspiration test was positive for blood, the needle was pulled back, and on reinjection the patient immediately had a severe generalized tonic-clonic seizure. The patient made a rapid recovery with no further treatment and was fully conscious after 2 minutes. 

A switch in neurotrophin requirements has been found for neurons which depend only on NGF for survival (sympathetic, dorsomedial trigeminal, jugular, some DRG cells Buj-Bello et al. (1994)). A wide range of these neurons show a switch from a transient early dependence on NT-3 and/or BDNF to a later dependence on NGF (for a review see Davies, 1994). For instance, up until ElO, survival of trigeminal ganglion neurons is dependent on BDNF and/or NT-3 later, when naturally programmed cell death takes place (E13-E18) these neurons require only NGF (Buchman and Davies, 1993). Similarly, the survival of NGF-dependent, but not BDNF-dependent, cranial sensory neurons is promoted by different neurotrophins early in their development (Buj-Bello et al.,... 

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