An unusual case of the syndrome of cervical rib with subclavian artery thrombosis and cerebellar and cerebral infarctions

Jusufovic, Mirza; Sandset, Else Charlotte; Popperud, Trine Haug; Solberg, Steinar; Ringstad, Geir; Kerty, Emı́lia

doi:10.1186/1471-2377-12-48

Cited by 17 publications

(9 citation statements)

References 18 publications

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“…Retrograde propagation of thrombus to the origin of the vertebral or common carotid arteries may occur next [3]. In some patients with TOS and associated stroke, thrombus extending into the innominate artery has been found on vascular imaging [6,7], and during surgery [8]. An alternative explanation is tran-sient retrograde flow within the SCA.…”

Section: Discussionmentioning

confidence: 99%

Thromboembolic stroke associated with thoracic outlet syndrome

Meumann¹,

Chuen²,

Fitt³

et al. 2014

Journal of Clinical Neuroscience

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Thoracic outlet syndrome occurs due to compression of the neurovascular structures as they exit the thorax. Subclavian arterial compression is usually due to a cervical rib, and is rarely associated with thromboembolic stroke. The mechanism of cerebral embolisation associated with the thoracic outlet syndrome is poorly understood, but may be due to retrograde propagation of thrombus or transient retrograde flow within the subclavian artery exacerbated by arm abduction. We report an illustrative patient and review the clinical features, imaging findings and management of stroke associated with thoracic outlet syndrome.

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Section: Discussionmentioning

confidence: 99%

Thromboembolic stroke associated with thoracic outlet syndrome

Meumann¹,

Chuen²,

Fitt³

et al. 2014

Journal of Clinical Neuroscience

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“…Common findings on physical examination consist of pulse less, pale and cold distal upper limb. One must have high suspicion for presence of cervical ribs when dealing with patients complaining of unilateral upper limb sensory and motor symptoms 16 . Unfortunately this patient had not received a proper initial physical assessment with a follow up plan and returned with a critically ischemic limb for surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

“…These mechanical factors may damage the intima and trigger clotting factors followed by aneurysm and thrombus formation. Further arterial compression with increase in symptoms can occur during rotation and elevation of arm 16 .…”

Section: Discussionmentioning

confidence: 99%

Critical Upper Limb Ischemia due to Subclavian Artery Compression Caused by Initially Undiagnosed Cervical Rib - A Case Report

et al. 2016

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True subclavian artery aneurysms are relatively rare events. Thoracic outlet compression is responsible for 75% of those aneurysms. They are formed as a result of compression of subclavian artery, for example a cervical rib. A case of subclavian artery aneurysm secondary to cervical rib in a 35 year old young adult, who presented with a critical ischemia in his dominant right upper limb. Plain x-ray of cervical spine revealed bilateral cervical ribs and duplex study of the both upper limb arteries concluded aneurysmal dilatation of mid-distal subclavian artery of both sides with mural thrombus on the right side, marked distal ischemia in the right upper limb due to occlusive thrombus in the distal arterial tree, normal distal arterial flow in the left upper limb. Although it is a rare lesion, cervical rib leading to thoracic outlet compression should always be included in the differential diagnosis of a critically ischemic limb in young age group. Surgical management should be considered in a patient with subclavian artery aneurysm due to cervical rib to prevent additional embolic events.University Heart Journal Vol. 11, No. 1, January 2015; 48-51

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“…Although subclavian artery thrombosis complicated by cerebral thromboembolism is uncommon, a number of case studies have reported on cerebral embolism from a subclavian artery thrombotic pathology 1). The pathogenesis of infarcts in the vertebrobasilar and carotid distribution is generally believed to be due to propagation or retrograde embolism from a subclavian artery thrombus.…”

Section: Discussionmentioning

confidence: 99%

Distal Subclavian Artery Occlusion Causing Multiple Cerebral Infarcts Consequence of Retrograde Flow of a Thrombus?

Baek

Shin

Kang

et al. 2013

J Cerebrovasc Endovasc Neurosurg

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Intracranial embolization usually arises from the heart, a vertebrobasilar artery, a carotid artery, or the aorta, but rarely from the distal subclavian artery upstream of an embolus. We report on a patient who experienced left shoulder and forearm pain with weak blood pressure and pulse followed by concurrent onset of left hemiplegia. This case is a rare example of multiple cerebral embolic infarctions, which developed as a complication of distal subclavian artery thrombosis possibly associated with protein S deficiency.

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An unusual case of the syndrome of cervical rib with subclavian artery thrombosis and cerebellar and cerebral infarctions

Cited by 17 publications

References 18 publications

Thromboembolic stroke associated with thoracic outlet syndrome

Thromboembolic stroke associated with thoracic outlet syndrome

Critical Upper Limb Ischemia due to Subclavian Artery Compression Caused by Initially Undiagnosed Cervical Rib - A Case Report

Distal Subclavian Artery Occlusion Causing Multiple Cerebral Infarcts Consequence of Retrograde Flow of a Thrombus?

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