The Experts below are selected from a list of 282 Experts worldwide ranked by ideXlab platform

Emilia Kerty - One of the best experts on this subject based on the ideXlab platform.

  • An unusual case of the syndrome of Cervical Rib with subclavian artery thrombosis and cerebellar and cerebral infarctions
    BMC neurology, 2012
    Co-Authors: Mirza Jusufovic, Else Charlotte Sandset, Trine Haug Popperud, Steinar Solberg, Geir Ringstad, Emilia Kerty
    Abstract:

    Cerebellar and cerebral infarctions caused by the syndrome of Cervical Rib with thrombosis of subclavian artery are very unusual. We report the case of a 49-year-old male patient with a right Cervical Rib compression leading to subclavian arterial thrombosis and both cerebellar and cerebral infarctions secondary to retrograde thromboembolisation. Follow-up imaging revealed partial resolution of the thrombosis after combined anti-coagulant and anti-platelet therapy. The Cervical Rib and first costa were surgically removed to prevent additional events. Cervical Rib vascular compression should be promptly diagnosed and treated in order to avoid further complications, including cerebrovascular ischemic events.

Christopher A. Parry - One of the best experts on this subject based on the ideXlab platform.

  • Thoracic outlet syndrome caused by pseudoarticulation of a Cervical Rib with the scalene tubercle of the first Rib
    Journal of vascular surgery, 2012
    Co-Authors: Anita Balakrishnan, Philip Coates, Christopher A. Parry
    Abstract:

    A healthy 20-year-old man presented with a bony lump above the left clavicle associated with upper limb pain, numbness, and tingling. Examination in the surrender position elicited left hand weakness and pain with loss of the radial pulse. The patient had paresthesia of the ulnar border of the left hand but no interossei wasting. A lateral neck radiograph identified an unusual bony contour anteriorly at C7/T1 suggesting a Cervical Rib (A). Duplex ultrasound scan showed widely patent left axillary and subclavian arteries with the arm adducted but severe compression of the subclavian artery on abducting the arm to 90°. A subsequent computed tomography angiogram confirmed bilateral Cervical Ribs; the left articulating with an extended left transverse process of the seventh Cervical vertebra, extending inferiorly to fuse with the first Rib (B and C/Cover). The left subclavian artery passed immediately superior to this bony extension whereas the left vertebral artery lay immediately anterior to the origin of the Cervical Rib at C7. The right Cervical Rib was much smaller and not in proximity to the vessels. Intraoperatively, the left Cervical Rib was found to extend from the C7 transverse process to form a true joint with a hypertrophied scalene tubercle on the first Rib; both the Cervical Rib and hypertrophied scalene tubercle were excised via the supraclavicular incision (D). A T1 sensory and motor neuropraxia was noted day 1 postsurgery which, together with his preoperative symptoms, completely resolved within 5 days and continued at 5-month follow-up. Cervical Ribs are a known cause of arterial and neurogenic thoracic outlet syndrome. These congenital abnormalities occur in 1% of the population but are bilateral in 50%. Ninety percent are asymptomatic and do not require resection. Complete Cervical Ribs occur in approximately 25% of patients, most commonly attached to the first Rib by a fibrous band, or more rarely, as in this case, via a true joint, often with the scalene tubercle. Surgical management involves removal of the Cervical Rib; if this does not provide adequate decompression of the subclavian artery and the brachial plexus, removal of the first Rib should be done.

Arthur L. Jenkins - One of the best experts on this subject based on the ideXlab platform.

  • Minimally Invasive Resection of Symptomatic Cervical Rib for Treatment of Thoracic Outlet Syndrome
    World neurosurgery, 2020
    Co-Authors: Charlotte Hawks, Sarah Herrera-nicol, Mark E. Pruzansky, Arthur L. Jenkins
    Abstract:

    Background Neurogenic thoracic outlet syndrome treatments have high morbidity and recurrence rates. We present for the first time to our knowledge a minimally invasive spine surgery technique for complete resection of a Cervical Rib via a costotransversectomy approach. Case Description A patient with an 8-year history of progressive thoracic outlet syndrome presented with right C8 pain, weakness, and atrophy of her right forearm and thenar eminence. After neurogenic thoracic outlet syndrome was confirmed via electromyography and imaging revealed bilateral Cervical Ribs (right more than left), the patient underwent a minimally invasive spine surgery resection of the Rib via a costotransversectomy and was discharged home the same day. The patient's pain and weakness gradually improved over a 2-year follow-up period. Conclusions Resection of a Cervical Rib via minimally invasive spine surgery costotransversectomy is safe and well tolerated compared with existing surgical treatments such as transaxillary, supraclavicular, and infraclavicular approaches.

Julie A. Freischlag - One of the best experts on this subject based on the ideXlab platform.

  • The significance of Cervical Ribs in thoracic outlet syndrome
    Journal of vascular surgery, 2013
    Co-Authors: Kevin Chang, Kendall C. Likes, Kylie Davis, Jasmine Demos, Julie A. Freischlag
    Abstract:

    Objective The purpose of this study was to review our operative experience in patients with thoracic outlet syndrome (TOS) resulting from Cervical Ribs causing clinical symptoms. Methods This study is a retrospective review of a prospectively acquired database of patients with TOS treated with first Rib resection and scalenectomy with or without Cervical Rib resection at the Johns Hopkins Medical Institutions. Results Between October 2003 and June 2011, a total of 23 Cervical Rib resections were performed on 20 patients, three of whom had bilateral Cervical Ribs resected during separate operations. Seven patients presented with subclavian artery thrombosis. Three of seven patients had subclavian artery aneurysms and underwent Cervical Rib resection through a supraclavicular approach to facilitate subclavian artery bypass. Five patients presented with an ischemic upper extremity without thrombosis and underwent transaxillary first Rib and Cervical Rib resection. Three patients presented with subclavian vein thrombosis; two of the three patients underwent balloon dilation 2 weeks postoperatively for stenosis. Additionally, five patients presented with neurogenic TOS evidenced by pain, numbness, and weakness without vascular compromise in the affected arm. Cervical Ribs with bony fusion to the first Rib were found in 17 of 23 cases (74%). Conclusions Cervical Ribs causing clinical symptoms are large and frequently fused to the first Rib, and can result in aneurysm formation or thrombosis. In our experience, both the Cervical Rib and the first Rib must be removed to relieve arterial compression and can usually be done through a transaxillary approach. Only patients with aneurysms needing arterial reconstruction require resection of the artery from a supraclavicular approach.

Praveen Bhardwaj - One of the best experts on this subject based on the ideXlab platform.