Hemiplegia and contralateral upper limb claudication - A case of dual disability from pseudoaneurysm of the brachiocephalic artery: A brief report

Richard L Harvey*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Thromboembolic obstruction of the brachiocephalic artery can have significant functional consequences because it threatens arterial circulation to the right upper limb and right cerebrum. A case is presented of a young man who sustained right basal ganglia infarct 2 mo after suffering multiple gunshot wounds to his chest. The severity of his hemiplegia rendered his left arm nonfunctional. Later, he developed progressive symptoms of right upper limb claudication, making it impossible to perform activities of daily living independently with the hemiplegic technique. Arteriography revealed a pseudoaneurysm near the bifurcation of the brachiocephalic artery; the likely source was thromboembolism to the right common carotid and right subclavian artery. Surgical ligation of the subclavian artery and vascular bypass from the common carotid to the brachial artery restored blood flow to his right upper limb. The arm claudication was relieved, and he was again able to perform activities of daily living independently. This case represents an unusual cause of dual disability with bilateral upper limb dysfunction from a single thromboembolic source. Accurate diagnosis and treatment prevented this patient from developing permanent impairment and restored him to functional independence.

Original languageEnglish (US)
Pages (from-to)56-59
Number of pages4
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume78
Issue number1
DOIs
StatePublished - Jan 1 1999

Keywords

  • Activities of Daily Living
  • Brachiocephalic Artery
  • Cerebral Infarction
  • Intermittent Claudication

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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