Transcript
Page 1: CT Angiogram - Hypoplastic Vertebral, Subclavian

Dr Jishanth MProf P Chitrambalam’s Unit

Stanley Medical College

Page 2: CT Angiogram - Hypoplastic Vertebral, Subclavian

Mrs Jaya, 32 yrs/F Admitted for pain suggestive of claudication of left

upper limb – 2years Episodic head ache -2 weeks

Past history of monoparesis of left upper limb 10 years back

Married 13 yrs back, one child, h/o induced abortion 2 yrs back

Page 3: CT Angiogram - Hypoplastic Vertebral, Subclavian

Conscious , oriented No facial asymmetry No asymmetry of limbs No pallor, jaundice,

cyanosis PULSE:• Rate- 84/ min• Regular, normal in volume

and character• Absent on left UL( both

radial and brachial pulses absent)

• Other peripheral pulses normal

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BLOOD PRESSURE R UL 120/80 L UL – not recordable R LL 140/90 L LL 140/90

CVS s1, s2 normal ,No murmers Subclavian bruit + on Left side No carotid bruit

RS - normal

Abdomen- No renal bruit, no femoral bruit

Nervous System examn.. Higher functions normal, Cranial nerves intact. No motor or sensory deficit No meningeal signs Fundus - normal

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Hb 11.4 g%TC 7500DC P69L28E3ESR 6/14 mmPlatelets 1.2 LRFT normalECG normalCXR normalX ray cervical spine – normalCT Brain- normal studyUSG Abdomen – normal study

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Cardiac evaluation was normal Echo was normal with normal LV systolic

function No evidence of great vessel disease

Suggested CT angiogram Ophthalmology evaluation normal ENT opinion CT PNS- mild DNS to left, bilateral

maxillary, ethmoidal and sphenoidal sinusitis

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Hypoplastic left vertebral artery Right upperlimb vessels normal Left subclavian artery appears

hypoplastic from its origin( 3mm in diameters)

Thin stream of contrast noted in the proximal left axillary artery with suspicious thickening of its wall.

Distal axillary artery is reformed through chest wall collaterals.

Brachial artery appears normal with normal radial and ulnar arteries.

Superficial and deep palmar arch formed normally.

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