Acute cerebellar ischaemic stroke secondary to arterial thoracic outlet syndrome

J Surg Case Rep. 2022 Jun 24;2022(6):rjac296. doi: 10.1093/jscr/rjac296. eCollection 2022 Jun.

Abstract

Arterial thoracic outlet syndrome comprises a collection of symptoms due to compression of the neurovascular structures of the thoracic outlet. Cervical ribs are rare congenital abnormalities that are a cause of thoracic outlet syndrome, leading to upper limb complications depending on the compressed structure. Management tends to be surgical in the form of rib resection. We report a case of arterial thoracic outlet syndrome secondary to a cervical rib in a 45-year-old male who presented with left-sided cerebellar stroke caused by subclavian artery thrombosis. Medical management in the form of anticoagulation was favoured. Oedema in the recent peri-infarct zone due to reperfusion may have caused compression of the fourth ventricle due to anatomical proximity, with the risk of further neurological compromise and coning. At follow-up appointments, the patient had no residual upper limb or neurological symptoms.

Keywords: Cervical rib; Stroke; Thoracic outlet syndrome; Vascular surgery.

Publication types

  • Case Reports