Integrative Bilateral Cervical Sympathetic Blocks for Trauma-Related Symptoms in Special Operations Veterans: A Prospective Case Series

Who May Qualify: - 18 years or older - PTSD (PCL Score of 33 or greater at baseline screening) - Willing and able to provide willing to sign a consent form and complete study procedures - Fluent in English - Special Operations Forces Veteran Who Should NOT Join This Trial: - Recent Sympathetic Block: Receipt of any cervical sympathetic block (including stellate ganglion block \[SGB\], dual sympathetic ganglion block \[DSGB\], or bilateral SGB/BCSB), whether unilateral or bilateral, within the past 6 months. - Concurrent interventional clinical trial participation: Currently enrolled in another interventional clinical trial or receiving any experimental treatment targeting PTSD, TBI, or autonomic dysfunction during the study period - Acute Psychiatric Instability: Currently experiencing acute psychiatric crisis requiring inpatient care, active suicidal or homicidal intent, or untreated mania, psychosis, or severe dissociation - Medical Contraindications to BCSB: Any known anatomical abnormalities, bleeding disorders, allergy to local anesthetics, pregnancy, or comorbidities that represent a contraindication to receiving a cervical sympathetic block, per the treating physician's judgment. - Language or communication barriers: Inability to read, speak, or understand English sufficiently to complete willing to sign a consent form and study assessments - Low PTSD Symptom Severity at Baseline: PCL-5 Score \< 33 at screening, indicating subclinical or minimal PTSD symptoms (Rationale: to ensure measurable clinical benefit and reduce floor effects) Always talk to your doctor about whether this trial is right for you.