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KMID : 0882420080750050602
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Korean Journal of Medicine
2008 Volume.75 No. 5 p.602 ~ p.606
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A case of arterial thoracic outlet syndrome presenting with upper extremity thrombus and thromboembolic cerebral infarction
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An Ho-Jung
Sung Mi-Sook
Min Jun-Ki
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Abstract
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Thoracic outlet syndrome (TOS) manifests as a spectrum of symptoms that are produced by compression of neurovascular bundles as they pass through the scalene muscles, clavicle, and the first rib. When a vascular structure like
subclavian artery is involved, TOS may result in serious complications, such as thromboembolism at distal extremities or,
more rarely, the brain. Here, we present a case of 25-year-old male presenting with Raynaud’s phenomenon, finger tip
necrosis, and left-sided hemiplegia secondary to thromboembolism associated with arterial TOS. Radiologic studies,
including simple X-ray, neck computed tomography (CT) angiography, thoracic aortography, and cerebral angiography,
revealed anomalous articulation of the right first rib to the second rib, right subclavian artery stenosis with poststenotic
dilatation and intramural thrombus, and thromoboembolism of the right distal internal carotid artery (ICA). The patient
successfully underwent resection of the anterior scalene muscle and embolectomy.
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KEYWORD
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Anomalous first rib, Thoracic outlet syndrome, Thromboembolism
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