Brachial plexopathy secondary to mycotic subclavian-axillary artery aneurysm

✍ Scribed by Martin Veilleux; Pierre Bourgouin; Jean-François Morin

• Book ID: 101253782
• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 225 KB
• Volume: 19
• Category: Article
• ISSN: 0148-639X
• DOI: 10.1002/(sici)1097-4598(199601)19:1<92::aid-mus13>3.0.co;2-5

✦ Synopsis

Aneurysm of the subclavian and axillary arteries is a rare peripheral vascular disease most frequently reported in penetrating axillary artery Transaxillary angiography,'* inadvertent arterial puncture,' and penetrating injuries result in false aneurysm. Causes of true subclavian-axillary aneurysm include atherosclero~is,'.~ syphilis, thoracic outlet obstruction,' shoulder trauma and dislocation, 1,1,10 and medial cystic n e c r ~s i s . ~ Because of its close relationship with the brachial plexus at the thoracic outlet, an expanding aneurysm of the subclavian-axillary artery can seriously damage the brachial plexus.* Most atherosclerotic aneurysms are asymptomatic,".' and, in posttraumatic axillary aneurysm, a delay in the diagnosis is common ranging from several weeks to T o our knowledge, a presumed mycotic subclavian and axillary aneurysm associated with severe, rapidly progressive brachial plexopathy has never been described.

CASEREPORT

An 86-year-old man with a past history of chronic alcohol abuse and residual blindness of the left eye possibly due to a left central retinal artery thrombosis, was admitted to the hospital on March 3, 1990 for confusion, pain, and discoloration of the right hand thought to be due to acute arterial em-From the Division of Neurology (Dr Veilleux),