Abstract

S TIMULATION or overactivity of sympathetic nerve fibers supplying the extremities produces vasoconstriction, pallor, coolness of the skin, and sweating. Interruption of sympathetic innervation causes the reverse, namely, vasodilation, a red, warm skin, and anhidrosis. Sympathectomies have been performed in the past mainly for the improvement of the peripheral vascular circulation in Raynaud's disease or obliterative arterial conditions, for the alleviation of arterial hypertension, and, less frequently, for the relief of pain in causalgia and for the elimination of excessive sweating. An apparently adequate sympathectomy may fail to relieve the symptoms for which it was performed, either immediately or after a prolonged interval. Reinnervation or regrowth of severed sympathetic nerve fibers has been postulated as the cause of failure in the second instance. However, another cause of failure is due to the presence of aberrant sympathetic ganglia which do not synapse in the sympathetic ganglionic chain and are therefore preserved following technically adequate sympathectomies.

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