Kawahara Ichiro, Nakamoto Morito, Matsuo Yoshitaka, Tokunaga Yoshiharu
Department of Neurosurgery, Nagasaki Prefecture Shimabara Hospital, Japan.
No Shinkei Geka. 2010 May;38(5):473-6.
Subclavian steal syndrome (SSS) is caused by hypoplasia of a vertebral artery or stenosis or occlusion of the subclavian artery or the brachiocephalic artery with subsequent retrograde filling of the subclavian artery via the contralateral vertebral artery. Symptoms of SSS are due to vertbrobasilar insufficiency or ischemia of the ipsilateral upper extremity, and they may include dizziness, syncope, ataxia, arm claudication, hand numbness or a decrease in brachial blood pressure on the affected side. However, most SSS cases are asymptomatic and they are classified as subclavian steal phenomenon (SSP). Atherosclerosis is the common cause of SSS, and Takayasu arteritis, neurofibromatosis, trauma, embolization, congenital vascular anomalies and surgical interruption of the subclavian artery can be identified among the other causes. We describe a rare case of hypervascular thyroid nodule presenting with features of SSP. The patient was hospitalized with acute cerebral infarction due to middle cerebral artery (MCA) severe stenosis. The patient had conservative therapy in the acute stage, and underwent STA-MCA anastomosis for MCA stenosis in the chronic stage. SSS was asymptomatic although there was laterality in blood pressure in the patient's bilateral upper limbs. Thyroid tumor was regarded as benign by radiological findings, laboratory data, and physical examination. If SSS becomes symptomatic, removal of the thyroid tumor may be indicated.
锁骨下动脉盗血综合征（SSS）是由椎动脉发育不全或锁骨下动脉或头臂干动脉狭窄或闭塞，随后通过对侧椎动脉逆行充盈锁骨下动脉引起的。SSS的症状是由于椎基底动脉供血不足或同侧上肢缺血，可能包括头晕、晕厥、共济失调、上肢间歇性跛行、手部麻木或患侧肱动脉血压降低。然而，大多数SSS病例无症状，被归类为锁骨下动脉盗血现象（SSP）。动脉粥样硬化是SSS的常见病因，其他病因包括高安动脉炎、神经纤维瘤病、创伤、栓塞、先天性血管异常和锁骨下动脉手术中断。我们描述了一例表现为SSP特征的高血管性甲状腺结节罕见病例。该患者因大脑中动脉（MCA）严重狭窄导致急性脑梗死住院。患者在急性期接受了保守治疗，在慢性期因MCA狭窄接受了STA-MCA吻合术。尽管患者双侧上肢血压存在差异，但SSS无症状。根据影像学检查结果、实验室数据和体格检查，甲状腺肿瘤被认为是良性的。如果SSS出现症状，可能需要切除甲状腺肿瘤。
