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[Arterial thoracic outlet syndrome and diagnostic angioresonance]
I Tobalina1, L C Alvaro-González, L García-Andrade
1Sección de Neurología, Hospital de Basurto, Bilbao, España.
Introduction:
The anatomy of the upper cervical region, in the presence of structural anomalies favours the compression of the brachial plexus and/or subclavian vessels, giving rise to the thoracic inlet syndrome (SATS). Neurological involvement is more common than vascular involvement (95 and 5% respectively); the latter is known as the arterial SATS. The forms of clinical presentation of arterial SATS are very variable and have different prognoses: it may present as acute distal ischaemia with a variable course, peripheral embolism or as a non-serious condition such as Raynaud's phenomenon.
Clinical Case:
We present a case with arterial involvement only, associated with a clavicular osteophyte, in a patient with episodes of acute, transient weakness of the arm which were initially thought to be transient strokes with brachial monoparesis.
Conclusion:
Classically, the basic examination to diagnose arterial SATS has been conventional angiography, an invasive test which is not without complications; in our case it was magnetic angioresonance which showed changes in blood flow on forced arm movement. This avoided having to do a conventional angiogram. Angioresonance, rarely cited in this syndrome, is worthy of study and comparison with the 'standard' diagnostic method of conventional angiography.