CT Angiogram - Hypoplastic Vertebral, Subclavian

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Text of CT Angiogram - Hypoplastic Vertebral, Subclavian

  • 1. Dr Jishanth M Prof P Chitrambalams Unit Stanley Medical College

2.

  • 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

3.

  • 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

4.

  • 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 orsensory deficit
      • No meningeal signs
      • Fundus - normal

5.

  • Hb 11.4 g%
  • TC7500
  • DCP69L28E3
  • ESR 6/14 mm
  • Platelets 1.2 L
  • RFT normal
  • ECG normal
  • CXRnormal
  • X ray cervical spine normal
  • CT Brain- normal study
  • USG Abdomen normal study

6. 7. 8.

  • 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

9. 10. 11. 12. 13. 14. 15.

  • 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 theproximal left axillary arterywith suspicious thickening of its wall.
  • Distal axillary artery is reformedthrough chest wall collaterals.
  • Brachial artery appears normal with normal radial and ulnar arteries.
  • Superficial and deep palmar arch formed normally.

16.