Martins Roberto S, Siqueira Mario G
Department of Neurosurgery, Hospital Santa Marcelina, São Paulo, Brazil.
Pediatr Neurosurg. 2007;43(4):293-6. doi: 10.1159/000103309.
Thoracic outlet syndrome in children is an extremely rare disorder. Only 5 previous reports were presented in the literature with a description of thoracic outlet syndrome in 8 children. In these cases, the diagnosis of a cervical rib was common. We describe a case of neurogenic thoracic outlet syndrome in a 9-year-old patient where the initial symptoms occurred 2 months after a fall. Clinically, the patient developed progressive pain, numbness and tingling along the inner surface of the left forearm and in the palmar surface of the fourth finger and lateral aspect of the fifth finger. A plain radiography showed a cervical rib fracture and an electrophysiologic study suggested the presence of left lower brachial plexus neuropathy. Her fractured cervical rib was resected through a supraclavicular approach. Her symptoms resolved completely in the postoperative period. Although very rare one should keep in mind the possibility of thoracic outlet syndrome in children, especially with a history of trauma over the shoulder girdle presenting with a cervical rib and a lower brachial plexopathy.
儿童胸廓出口综合征是一种极为罕见的疾病。文献中仅先前报道过5例，描述了8名儿童的胸廓出口综合征。在这些病例中，颈肋的诊断很常见。我们描述了一例9岁神经源性胸廓出口综合征患者，其最初症状在跌倒后2个月出现。临床上，患者沿左前臂内表面、第四指掌面和第五指外侧出现进行性疼痛、麻木和刺痛。X线平片显示颈肋骨折，电生理研究提示存在左下肢臂丛神经病变。通过锁骨上入路切除了她骨折的颈肋。术后她的症状完全缓解。尽管非常罕见，但应牢记儿童发生胸廓出口综合征的可能性，尤其是有肩带部创伤史、伴有颈肋和下臂丛神经病变的情况。
