Definition:

It is a condition that involves compression of neurovascular structures at the exit of the thorax. It can affect the brachial plexus, the subclavian artery or vein.

The symptoms of the syndrome may vary depending on the type..

When nerves are compressed (neurogenic), this includes:

• Numbness or tingling in the arm or fingers. Pain or discomfort in the neck, shoulder, arm, or hand. Arm fatigue with activity. Weakness in the grip.

Venous SDT symptoms may include:

• Venous thrombosis of the subclavian or axillary vein.

Arterial SDT symptoms include:

• A throbbing lump near the collarbone. Cold fingers, hands, or arms. Pain in the hand and arm. A change in colour in one or more fingers or the entire hand. Weak or absent pulse in the affected arm.

The following tests are required to make an accurate diagnosis:

• Cervical-thoracic CT angiography/Cervical-thoracic MR angiography with compression manoeuvres
• Dynamic Doppler ultrasound of upper limbs
• Electromyography of upper limbs

Once the diagnosis has been made, surgical decompression is approached in a multidisciplinary manner. Concomitantly, during surgery, neuromonitoring services are available to monitor the brachial plexus and nerve structures.

After hospital treatment, the patient is referred to the Neurorehabilitation Service to consolidate the results obtained with surgical decompression.

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