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. 2018 Feb 28;13(1):e1-e3.
doi: 10.1055/s-0037-1607977. eCollection 2018 Jan.

Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases

Amgad Hanna  1 , Larry O'Neil Bodden  1 , Gabriel R L Siebiger  2
Affiliations

Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases

Amgad Hanna et al. J Brachial Plex Peripher Nerve Inj. .

Abstract

Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus.

Keywords: microvascular decompression; thoracic outlet syndrome; vascular compression.

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Figures

Fig. 1
Fig. 1
First case. ( A ) Right brachial plexus exposure showing compression of the lower trunk of the brachial plexus (L) by a branch from the subclavian artery (A) and a vein. Scalenus anterior muscle edge after partial scalenectomy (S), phrenic nerve (P), upper trunk (U), middle trunk (blue arrow). ( B ) A right-angled instrument is used to lift up the vessels off the lower trunk of the brachial plexus. Shredded Teflon is then used for separation.
Fig. 2
Fig. 2
Second case. ( A ) A vessel (arrow) was found to pass between the middle (M) and upper (U) trunks of the brachial plexus. This was ligated and cut ( B ). P, phrenic nerve.
See this image and copyright information in PMC

References

    1. Kuhn J E, Lebus V G F, Bible J E. Thoracic outlet syndrome. J Am Acad Orthop Surg. 2015;23(04):222–232. - PubMed
    1. Laulan J, Fouquet B, Rodaix C, Jauffret P, Roquelaure Y, Descatha A. Thoracic outlet syndrome: definition, aetiological factors, diagnosis, management and occupational impact. J Occup Rehabil. 2011;21(03):366–373. - PMC - PubMed
    1. Tubbs R S, Tyler-Kabara E C, Salter E G, Sheetz J, Zehren S J, Oakes W J. Additional vascular compression of the brachial plexus in a cadaver with a cervical rib: case illustration. Surg Radiol Anat. 2006;28(01):112–113. - PubMed
    1. Chloros G D, Crosby N, Apel P, Li Z. Anomalous vasculature as direct cause of upper brachial plexus thoracic outlet syndrome. Joint Bone Spine. 2009;76(01):92–94. - PubMed
    1. Verenna A A, Alexandru D, Karimi A et al.Dorsal scapular artery variations and relationship to the brachial plexus, and a related thoracic outlet syndrome case. J Brachial Plex Peripher Nerve Inj. 2016;11(01):e21–e28. - PMC - PubMed