Thoracic Outlet Syndrome

A neurovascular syndrome associated with compression of the brachial plexus; subclavian artery; and subclavian vein at the superior thoracic outlet. This may result from a variety of anomalies such as a cervical rib (cervical rib syndrome), anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, paresis or paralysis of brachial plexus innervated muscles, paresthesia, loss of sensation, reduction of arterial pulses in the affected extremity, ischemia, and edema. (Adams et al., Principles of Neurology, 6th ed, pp214-5).