A Rare Case of Stroke in an Adolescent Violinist Due to Thoracic Outlet Syndrome

Kuril, Sandeepkumar; Chopade, Pramod; Mandava, Mamatha; Bhatia, Sonal

doi:10.4103/0028-3886.333506

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…While stroke has been reported as a complication of arterial TOS, 2 , 3 , 7 this is the first description of a paradoxical embolus associated with a venous TOS in the setting of atrial septal defect. Interestingly, an analogous condition has been described with co-occurrence of PFO and May-Thurner syndrome, in which chronic compression of the left common iliac vein by the overlying right common iliac artery results in iliofemoral deep vein thrombosis and has been associated with paradoxical stroke.…”

Section: Discussionmentioning

confidence: 85%

Cortical Hand Knob Paradoxical Thromboembolic Stroke in an Adolescent with Secundum Atrial Septal Defect and Paget-Schroetter Syndrome

Parfyonov,

Porritt,

Peacock

et al. 2024

Child Neurology Open

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Venous thoracic outlet syndrome (vTOS) is an increasingly recognized diagnosis in young patients in which the subclavian vein is compressed within the costoclavicular space. With repetitive compression, thrombosis can develop and has been referred to as “effort thrombosis” or the Paget-Schroetter syndrome. Here, we present a 16-year-old boy with vTOS who presented with acute ischemic stroke (AIS) in the hand knob region of precentral gyrus due to paradoxical embolus in the setting of atrial septal defect.

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Section: Discussionmentioning

confidence: 85%

Cortical Hand Knob Paradoxical Thromboembolic Stroke in an Adolescent with Secundum Atrial Septal Defect and Paget-Schroetter Syndrome

Parfyonov,

Porritt,

Peacock

et al. 2024

Child Neurology Open

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“…TOS can occur from compression of the subclavian artery from a bony structure (such as a cervical rib) and can lead to thrombus formation and stroke. Risk factors for TOS include activities that involve repetitive movement of extreme abduction and external rotation of the shoulders [ 105 ]. The mechanism through which TOS leads to stroke is unclear.…”

Section: Introductionmentioning

confidence: 99%

Advances in the Diagnosis and Treatment of Pediatric Arterial Ischemic Stroke

Sun

Lynch

2023

Neurotherapeutics

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Though rare, stroke in infants and children is an important cause of mortality and chronic morbidity in the pediatric population. Neuroimaging advances and implementation of pediatric stroke care protocols have led to the ability to rapidly diagnose stroke and in many cases determine the stroke etiology. Though data on efficacy of hyperacute therapies, such as intravenous thrombolysis and mechanical thrombectomy, in pediatric stroke are limited, feasibility and safety data are mounting and support careful consideration of these treatments for childhood stroke. Recent therapeutic advances allow for targeted stroke prevention efforts in high-risk conditions, such as moyamoya, sickle cell disease, cardiac disease, and genetic disorders. Despite these exciting advances, important knowledge gaps persist, including optimal dosing and type of thrombolytic agents, inclusion criteria for mechanical thrombectomy, the role of immunomodulatory therapies for focal cerebral arteriopathy, optimal long-term antithrombotic strategies, the role of patent foramen ovale closure in pediatric stroke, and optimal rehabilitation strategies after stroke of the developing brain. Supplementary Information The online version contains supplementary material available at 10.1007/s13311-023-01373-5.

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Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report

et al. 2022

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Thoracic outlet syndrome (TOS) is a condition that results from the compression of neurovascular structures as they exit the thorax. Arterial ischemic stroke can occur in TOS due to retrograde embolism from the subclavian artery. We describe a 15-year-old girl who presented with left hemiplegia after 2 weeks of right arm numbness and tingling. Imaging showed an acute ischemic stroke due to a right middle cerebral artery occlusion. She was treated with intravenous tissue plasminogen activator at 1.3 h and mechanical thrombectomy at 2.4 h with successful recanalization. Review of her neck computed tomography angiogram suggested a right subclavian artery aneurysm, and upper-extremity imaging also demonstrated distal thrombosis and fusion of right first and second ribs, which was consistent with thoracic outlet syndrome. Three days later, she underwent a right subclavian artery aneurysm repair, right brachial and ulnar artery thrombectomy, and first rib resection. Three months later, she demonstrated good neurologic recovery. TOS is an uncommon cause of stroke in children, which may be heralded by upper-extremity symptoms. Interventionalists should be aware of the possibility of vascular anomalies in children; however, this finding does not exclude the possibility of acute stroke intervention.

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A Rare Case of Stroke in an Adolescent Violinist Due to Thoracic Outlet Syndrome

Cited by 3 publications

References 13 publications

Cortical Hand Knob Paradoxical Thromboembolic Stroke in an Adolescent with Secundum Atrial Septal Defect and Paget-Schroetter Syndrome

Cortical Hand Knob Paradoxical Thromboembolic Stroke in an Adolescent with Secundum Atrial Septal Defect and Paget-Schroetter Syndrome

Advances in the Diagnosis and Treatment of Pediatric Arterial Ischemic Stroke

Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report

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