Articles of the Month
The Cervical Disc Syndrome: Differential Diagnosis and Management Based on Twenty-six Operated Cases*
The Cervical Disc Syndrome: Differential Diagnosis and Management Based on Twenty-six Operated Cases*
When Thoracic Outlet Syndrome is an Emergency
Paradoxical Cerebral Embolism in a Patient with Paget-Schroetter Syndrome
"A 28-year-old man presented with transient speech disturbance and right hemiplegia. Computed tomography of the brain revealed a low-density area in the right cerebellum. A ventilation/perfusion lung scintiscan detected multiple perfusion defects in the both lungs and catheterization revealed pulmonary..."
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Upper Extremity Deep Venous Thrombosis
"Purpose: Although much attention has been focused on lower extremity deep venous thrombosis (LEDVT), there is a relative paucity of data regarding upper extremity deep venous thrombosis (UEDVT). While previous literature has suggested that UEDVT is a benign self-limited process with little risk of pulmonary embolism, we noted a significant associated mortality and incidence of pulmonary embolism. To increase our knowledge with the patho logy of UEDVT, we have reviewed our experience..."
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Severe Limb-Threatening Ishchemia-Thoracic Outlet Syndrome
"Thoracic outlet syndrome (TOS) is a well described clinical entity that occurs in adults, with nerve compression being the most common presentation. The term TOS was introduced by Peet et al in 1956 and was later defined by Rob and Standeven as a set of symptoms that may exist due to compression on the brachial plexus and subclavian vessels in the region of the thoracic outlet..."
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Subclavian Artery Aneurysm: Frequently Asked Questions.
"What is an Aneurysm? An aneurysm is an abnormal dilation of a blood vessel. This involves all layers of the vessel wall. Aneurysms pose a risk to health due to their potential to rupture, thrombose or embolize. The most common blood vessels involved are the abdominal and thoracic aorta, and circle of Willis (brain). Aneurysms of the subclavian artery (under the clavicle) are uncommon, accounting for less than 1% of all peripheral aneurysms."
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Reported in-hospital complications following rib resections for neurogenic TOS
"David C., Anne O. Susanna L., Freischlag Julie A. While brachial plexus injury has been described as the most common complication following thoracic outlet syndrome (TOS) operation and case series have been reported, the exact incidence rate has not been described. We conducted a retrospective analysis of 5 years (1999-2003) of the Nationwide Inpatient Sample database. Neurogenic TOS patients, rib resections, brachial plexus injuries, and vascular injuries are identified by ICD-9 diagnosis codes or procedure codes. A total of 2,016 TOS operations were..."
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Functional Subclavian Artery Compression Caused by Thoracic Outlet Syndrome
"A 68-year-old hypertensive man was admitted to our center for
a non-ST-elevation acute coronary syndrome with normal troponin
value. The clinical history was remarkable for enabliting pain
of the left upper arm. After a positive stress test, the patient
was scheduled for coronary angiography..."
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Canadian Journal of Emergency Medicine-Cervical Rib and Brachial Artery Thrombosis
"Results of the chest x-ray provided our clue (Fig. 1). A Doppler ultrasound study of the right upper limb revealed no flow in the brachial artery distal from the junction of the axillary artery with echogenic material, suggestive of a thrombus, in the brachial artery. Anticoagulation was commenced with intravenous heparin and the patient ultimately underwent brachial artery embolectomy. During exploration of the neck, the subclavian artery was found to lie in front of the cervical rib. Despite the finding of post-stenotic dilation, there was no thrombus with the artery at that level. The cervical rib was resected. One month after the procedure, the patient was..."
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Thoracic outlet syndrome mimicking angina pectoris with elevated creatine phosphokinase values
"Abstract-Four patients with elevated creatine phosphokinase (CPK) values and
recurrent chest pain were found to have thoracic outlet syndrome. This
association of abnormal CPK levels and chest pain due to thoracic outlet
syndrome has not been previously reported. Symptoms and CPK values improved
with anti-inflammatory medications and/or proper posture instruction..."
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