Naslov
Partial subclavian steal syndrome in a patient with subclavian artery anomaly and VACTERL syndrome

Autori
Budinčević, Hrvoje ; Starčević, Katarina ; Bielen, Ivan.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Acta Clinica Croatica 2011. 50(Suppl 2) / - , 2011

Skup
51st International Neuropsychiatric Pula Congress.

Mjesto i datum
Pula, Hrvatska, 15.06.2011. - 18.06.2011

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
subclavian steal syndrome

Sažetak
Introduction Subclavian steal syndrome refers to a pathological condition due to a proximal stenosis or occlusion of the subclavian artery. Most common cause of the steno-occlusive process is atherosclerosis. Others causes are unusual and include arteriopathies (Takayasu disease, temporal arteritis) and congenital lesions of the aortic arch or subclavian artery. Lusorian artery is a rare right subclavian artery anomaly with an incidence of 0, 5 – 2 %. It originates as the most distal aortic arch branch, and most commonly has a retroesophageal course thereby sometimes causing dysphagic difficulties (dysphagia lusoria). VACTERL syndrome is diagnosed when at least three of the following anomalies are present in a newborn: vertebral defects, anal atresia, cardiovascular anomalies (VSD being the most common one), esophageal atresia, renal anomalies, and limb defects. Case report This report describes a 22-year old Caucasian male who presented with a headache and vertigo following sudden and temporary loss of consciousness while attended a concert four days before hospital admission. His prior medical history includes a surgical repair of esophageal atresia as a newborn and a sonographically verified ventricular septal defect. Otherwise, he is heathy and without any other medical complaints. His complete physical and neurological exam was unremarkable. During hospitalization his chest x-ray detected a significant scoliosis at the cervico-thoracal junction and prominent rib overlap at the cervical C5-C6 level. Magnetic resonance of the cervical spine showed following vertebral anomalies: vertebral block between the C2 and C3, C5 and C6, hemivertebra at the C5/6 level and marked osteophytosis with foraminal narrowing at the C5 level. Detailed cardiac examination was done, including an ECG and a heart ultrasound, in order to exclude an underlying heart condition. Beside otherwise known ventricular septal defect, no pathologies were detected. Neurosonological examination revealed a reduced blood flow velocities through the right vertebral artery, with signs of retrograde flow during middle part of the cardiac cycle which corresponds to partial subclavian steal syndrome. MSCT angiography of the thoracal arteries confirmed an anomalous right subclavian artery, originating as the most distal branch of the aortic arch and coursing retroesophageally (lusorian artery). Conclusion Partial subclavian steal syndrome is rarely described in the literature as a consequence of an anomalous lusorian artery. What is completely unique about our patient is the concurrence of this vessel anomaly with a congenital syndrome, so-called VACTERL syndrome.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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