Wessely P, Deutsch M, Samec P
Wien Klin Wochenschr. 1984 Aug 3;96(15):589-92.
Mechanical irritation of the right subclavian artery in the scalenus region and stenosis of the contralateral subclavian artery in combination with hypoplasia of the vertebral artery led to recurrent neurological symptoms in a 41 year-old female patient. Sudden loss of consciousness, episodes of dizziness, vomiting and paraesthesiae occurred as a result of manoeuvres involving turning the head and lifting the right arm. A significant blood pressure difference between both arms and a stenotic bruit were found. Angiography revealed the "subclavian steal syndrome" with stenosis of the left subclavian artery and hypoplasia of the left vertebral artery. On operation of the right scalenus region an atypically angled origin of the right vertebral artery was detected. After dissection of the scalenus anticus muscle and-in a second step-transaxillary resection of the first rib the patient has remained symptom-free for the past 24 months.
一名41岁女性患者，因斜角肌区域右锁骨下动脉受到机械性刺激，对侧锁骨下动脉狭窄并伴有椎动脉发育不全，出现了反复的神经症状。转头和抬起右臂等动作导致患者突然意识丧失、头晕、呕吐及感觉异常发作。发现双臂血压存在显著差异，并伴有狭窄性杂音。血管造影显示为“锁骨下动脉窃血综合征”，左锁骨下动脉狭窄，左椎动脉发育不全。在对右斜角肌区域进行手术时，发现右椎动脉起始角度异常。在解剖前斜角肌并分两步经腋部切除第一肋后，患者在过去24个月里一直无症状。
