外展45度时手臂麻木：臂神经炎后胸廓出口综合征一例报告
Arm Numbness at 45 Degrees Abduction: A Case Report of Thoracic Outlet Syndrome After Brachial Neuritis.
作者信息
Fleet Jamie L, Harish Srinivasan, Bain James, Baker Steven K
机构信息
Division of Physical Medicine & Rehabilitation, Department of Medicine, McMaster University, Hamilton, Canada.
Department of Radiology, McMaster University, Hamilton, Canada.
出版信息
J Rehabil Med Clin Commun. 2020 Jun 15;3:1000034. doi: 10.2340/20030711-1000034. eCollection 2020.
OBJECTIVE
To describe a case of nerve kinking correlating with surgical findings in neurogenic thoracic outlet syndrome in a patient with history of brachial neuritis. Thoracic outlet syndrome and brachial neuritis are briefly reviewed.
CASE REPORT
A 32-year-old woman with a history of bilateral brachial neuritis presented with paraesthesias in her hand when abducting her shoulder to 45° or higher. A kink in the superior trunk of the brachial plexus, as well as asymmetrically narrowed costoclavicular space, was found on magnetic resonance imaging with the shoulder abducted. Conservative measures failed, leading to partial anterior scalenectomy and neurolysis, which led to improvement in her symptoms.
CONCLUSION
Anatomical variations in combination with biomechanical changes after brachial neuritis can be associated with neurogenic thoracic outlet syndrome.
目的
描述一例臂丛神经炎病史患者，其神经扭结与神经源性胸廓出口综合征手术所见相关的病例。简要回顾胸廓出口综合征和臂丛神经炎。
病例报告
一名有双侧臂丛神经炎病史的32岁女性，当肩部外展至45°或更高时手部出现感觉异常。磁共振成像显示，肩部外展时臂丛神经上干有扭结，以及锁骨下血管间隙不对称变窄。保守治疗无效，遂行部分前斜角肌切除术及神经松解术，症状得以改善。
结论
臂丛神经炎后的解剖变异与生物力学改变可能与神经源性胸廓出口综合征有关。
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