Cargando…

Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report

Thoracic outlet syndrome (TOS) is a condition that results from the compression of neurovascular structures as they exit the thorax. Arterial ischemic stroke can occur in TOS due to retrograde embolism from the subclavian artery. We describe a 15-year-old girl who presented with left hemiplegia afte...

Descripción completa

Detalles Bibliográficos
Autores principales: Angappan, Dhanalakshmi, Garrett, McKinnon, Henry, Candice, Riddle, Art, Wilson, Jenny L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221651/
https://www.ncbi.nlm.nih.gov/pubmed/35740812
http://dx.doi.org/10.3390/children9060875
_version_ 1784732674631401472
author Angappan, Dhanalakshmi
Garrett, McKinnon
Henry, Candice
Riddle, Art
Wilson, Jenny L.
author_facet Angappan, Dhanalakshmi
Garrett, McKinnon
Henry, Candice
Riddle, Art
Wilson, Jenny L.
author_sort Angappan, Dhanalakshmi
collection PubMed
description Thoracic outlet syndrome (TOS) is a condition that results from the compression of neurovascular structures as they exit the thorax. Arterial ischemic stroke can occur in TOS due to retrograde embolism from the subclavian artery. We describe a 15-year-old girl who presented with left hemiplegia after 2 weeks of right arm numbness and tingling. Imaging showed an acute ischemic stroke due to a right middle cerebral artery occlusion. She was treated with intravenous tissue plasminogen activator at 1.3 h and mechanical thrombectomy at 2.4 h with successful recanalization. Review of her neck computed tomography angiogram suggested a right subclavian artery aneurysm, and upper-extremity imaging also demonstrated distal thrombosis and fusion of right first and second ribs, which was consistent with thoracic outlet syndrome. Three days later, she underwent a right subclavian artery aneurysm repair, right brachial and ulnar artery thrombectomy, and first rib resection. Three months later, she demonstrated good neurologic recovery. TOS is an uncommon cause of stroke in children, which may be heralded by upper-extremity symptoms. Interventionalists should be aware of the possibility of vascular anomalies in children; however, this finding does not exclude the possibility of acute stroke intervention.
format Online
Article
Text
id pubmed-9221651
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-92216512022-06-24 Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report Angappan, Dhanalakshmi Garrett, McKinnon Henry, Candice Riddle, Art Wilson, Jenny L. Children (Basel) Case Report Thoracic outlet syndrome (TOS) is a condition that results from the compression of neurovascular structures as they exit the thorax. Arterial ischemic stroke can occur in TOS due to retrograde embolism from the subclavian artery. We describe a 15-year-old girl who presented with left hemiplegia after 2 weeks of right arm numbness and tingling. Imaging showed an acute ischemic stroke due to a right middle cerebral artery occlusion. She was treated with intravenous tissue plasminogen activator at 1.3 h and mechanical thrombectomy at 2.4 h with successful recanalization. Review of her neck computed tomography angiogram suggested a right subclavian artery aneurysm, and upper-extremity imaging also demonstrated distal thrombosis and fusion of right first and second ribs, which was consistent with thoracic outlet syndrome. Three days later, she underwent a right subclavian artery aneurysm repair, right brachial and ulnar artery thrombectomy, and first rib resection. Three months later, she demonstrated good neurologic recovery. TOS is an uncommon cause of stroke in children, which may be heralded by upper-extremity symptoms. Interventionalists should be aware of the possibility of vascular anomalies in children; however, this finding does not exclude the possibility of acute stroke intervention. MDPI 2022-06-12 /pmc/articles/PMC9221651/ /pubmed/35740812 http://dx.doi.org/10.3390/children9060875 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Angappan, Dhanalakshmi
Garrett, McKinnon
Henry, Candice
Riddle, Art
Wilson, Jenny L.
Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report
title Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report
title_full Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report
title_fullStr Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report
title_full_unstemmed Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report
title_short Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report
title_sort pediatric stroke due to thoracic outlet syndrome treated with thrombolysis and thrombectomy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221651/
https://www.ncbi.nlm.nih.gov/pubmed/35740812
http://dx.doi.org/10.3390/children9060875
work_keys_str_mv AT angappandhanalakshmi pediatricstrokeduetothoracicoutletsyndrometreatedwiththrombolysisandthrombectomyacasereport
AT garrettmckinnon pediatricstrokeduetothoracicoutletsyndrometreatedwiththrombolysisandthrombectomyacasereport
AT henrycandice pediatricstrokeduetothoracicoutletsyndrometreatedwiththrombolysisandthrombectomyacasereport
AT riddleart pediatricstrokeduetothoracicoutletsyndrometreatedwiththrombolysisandthrombectomyacasereport
AT wilsonjennyl pediatricstrokeduetothoracicoutletsyndrometreatedwiththrombolysisandthrombectomyacasereport