非典型胸廓出口综合征与逆流性血栓栓塞症
Atypical thoracic outlet syndrome and reverse flow thromboembolism.
作者信息
Bains Robert D, Platt Jennica, MacGregor Daune, Borschel Gregory H
机构信息
Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
出版信息
Pediatr Neurol. 2014 Sep;51(3):453-6. doi: 10.1016/j.pediatrneurol.2014.04.022. Epub 2014 Apr 24.
BACKGROUND
Thoracic outlet syndrome is rare in children but may have serious consequences. Compression of the neurovascular structures at the thoracic outlet by anomalous soft tissues or cervical ribs may cause neurological deficits in the upper limb and venous or arterial insufficiency.
PATIENTS
The symptoms and signs of this condition are well documented, but we describe two patients with an atypical presentation. We review similar published cases where delay in diagnosis resulted in cerebrovascular catastrophe. Our patients presented with relatively nonspecific central nervous system symptoms and were found to have thoracic outlet compression. Both were treated by surgical decompression of the thoracic outlet, and the symptoms completely resolved with no long-lasting neurological consequences.
CONCLUSIONS
We highlight the importance of these rare cases because of the risk of stroke and discuss the theory behind the pathological process.
背景
胸廓出口综合征在儿童中较为罕见，但可能会产生严重后果。异常软组织或颈肋对胸廓出口处神经血管结构的压迫可能导致上肢神经功能缺损以及静脉或动脉供血不足。
患者
这种疾病的症状和体征已有充分记载，但我们描述了两名表现不典型的患者。我们回顾了类似的已发表病例，其中诊断延误导致了脑血管灾难。我们的患者表现出相对非特异性的中枢神经系统症状，经检查发现存在胸廓出口受压情况。两人均接受了胸廓出口减压手术治疗，症状完全缓解，未留下长期神经功能后遗症。
结论
由于存在中风风险，我们强调了这些罕见病例的重要性，并讨论了病理过程背后的理论。
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