Thrombosis of aberrant right subclavian artery co-existing with infarction of left cerebellar hemisphere: Case report

Abstract

Anomalies of the aortic arch and its main branches are rare; estimations from autopsy series indicate a frequency of 3%. The incidence of an aberrant right subclavian artery is up to 0.5% of the population. A putrefied corpse of 59-year old women was found in her locked apartment seating in armchair. The autopsy as a direct cause of death revealed chronic heart failure. The autopsy also revealed aberant right subclavian artery occluded by thrombosis and acute infarction of the left cerebellar hemisphere. The purpose of this report is to describe an unusual case involving acute ischemia of the right upper extremity due to extensive thrombosis of a retroesophageal right subclavian artery (RSA) in a 59-year-old woman. In literature was described clinical presentation left hemiparesis caused by right subclavian artery thrombosis and retrograde embolization of thrombus via the common carotid artery to the right middle cerebral artery distribution. In our case, right subclavian artery thrombosis was co-existing with acute encephalomalation of the left cerebellar hemisphere. This may be result of retrograde embolization of thrombus via the left vertebral artery or hypercoagulability of blood with co-existing thrombosis of this two arteries. At autopsy we exclude existance of paradoxal thrombosis via atrial or vetricular septal defect or arterio-venous fistula, and also exclude existance of a thrombosis od left atrial auricula.